Significant risk of to self or others Urgent criteria To be discussed with the Duty Clinician for the Community CAMHS team and assessment arranged as is clinically indicated and as a maximum within 7 days Severe symptoms of depression with or without suicidal ideas/thoughts Symptoms of anorexia with over 20% deficit from ideal weight and/or significant physical risk Severe unexplained deterioration in emotional state and behaviour at home and school not thought to be due to drugs, alcohol or physical illness Assessment following deliberate and presentation at accident and emergency services. The referrer needs to identify the level of urgency of the case. If in doubt the referrer should contact the Community CAMHS Duty Clinician. Standard criteria There will be an emphasis on the need for assessment to ascertain presence or not of severe mental ill health and Community CAMHS contribution to management of complex cases. Factors to consider include: severity, complexity, enduring difficulties over time, difficulties in one or more domain, impairment of function at home, school or socially. Attention Deficit Hyperactivity Disorder (ADSHD) & Autistic Spectrum Disorder (ASD) Complex Attention Deficit Hyperactivity Disorder & Autistic Spectrum Disorder cases with mental health issues which meet Community CAMHS criteria Eating Disorders Anorexia: at least 15% deficit from ideal weight with associated psychopathology Bulimia: engaging in binge and purge behaviours Eating Disorders Not Otherwise Specified (EDNOS) with functional impairment or physical risk Psychotic Illness Positive symptoms – Paranoia, delusional beliefs, abnormal perceptions (hallucinations on all sensory modalities) Negative, symptoms – deterioration in self-care and daily personal, social and family functioning Disinhibited behaviour, over-activity, risk taking, with pressure of speech and agitation Severe depression with psychomotor retardation, social withdrawal, suicidal ideas/thoughts Anxiety Disorders Anxiety panic attacks Separation anxiety Phobias including phobic anxiety related to school Depression Physical symptoms: poor sleep / appetite / libido Cognitive symptoms: negative thoughts about self / others / world Suicidal ideas / thoughts: such as level of intent, current thought Co-morbidity: depression often occurs concurrently with other presenting mental health problems Post Traumatic Stress Disorder Symptoms occurring more than 1 month after a recognised traumatic event Intrusion and avoidance of thoughts and memories about the trauma harm
Facilitate timely discharge from hospital where hospital admission has been necessary Deliver intensive support for children, young people and their families and within the optimal therapeutic environment, by supporting and engaging them and their families by means of individualised home and community treatment packages Work with colleagues in Community CAMHS teams in the integrated model of care and other agencies to ensure appropriate follow-up care for the client once the acute phase of mental illness has passed and intensive home treatment is no longer necessary Out of Hours Out of Hours the OSCA team will provide a first response for all emergency clinical enquiries; they will provide consultation and advice and/or coordinate a psychiatric assessment if clinically indicated within 24 hours as a maximum. Significant risk of to self or others with mental health identified as the key contributing factor Presentation of severe psychotic symptoms Presentation of anorexia with serious physical side effects and/or rapid weight loss (e.g. BMI below 15, pulse rate 45 and below with low blood pressure) or co-morbidity with low mood / depression / suicidal ideas / thoughts Please note: consideration should initially be given to referral to paediatric or medical teams in the first instance if there is serious concern about the physical state Presentation of symptoms of severe depression with suicidal ideas / thoughts Presenting with significant self-harm by overdose or significant self-injury CAMHS Learning Disability service Referral criteria We will offer an assessment to children and young people who meet the following criteria: Have an identified emotional, mental health or behavioural difficulty Have a diagnosed learning disability or significant impairment of intellectual and social adaptive functioning Assessment indicates that other services involved with the child are not able to meet the current need if there are not the skills or competence available Children with Learning Disabilities often present mental health differently from that of children without Learning Disabilities. Therefore, in addition to the criteria for mental health listed this service will also address the following: Challenging behaviours of sufficient severity to destabilise placements, including physical and verbal aggression and self-injurious behaviours Severe disturbance in eating, self-care, toileting, relationships