Tameside Adolescent Mental Health Services Referral Criteria

All areas of Greater Manchester use the I-Thrive Model to navigate Children, Young People and families to the most appropriate mental health or wellbeing services.

In Tameside and Glossop there is a range of commissioned support for children’s young people and their families delivered in a range of community bases across the locality. Specialist mental health (Getting More Help / Getting Risk Support) is offered by CAMHS, but there is a range of community provision that offers counselling, peer support and psychosocial support, for Getting Advice or Getting Help.

When making a referral for mental health and emotional wellbeing, please consider; if a Specialist Mental Health Service is the most appropriate pathway at this stage, that the current difficulties have been present over the last four weeks and are at level where they are impacting on daily functioning. We would expect that most children, young people and or carers will have already received either a universal, primary care or social care first line support service / intervention before referring on to CAMHS.

A range of open access walk-in sessions from the Community Hive, or online support from Kooth, can support the young person in Getting Advice or Getting Help, without needing specialist support from CAMHS.

The Single Point of Access to Mental Health is collocated with the Early Help Access Point and Safeguarding Hub and the team will triage referrals holistically, to ensure the right support is offered at the right time, for every referral. A SPOA referral is a mental health referral, not a CAMHS referral, so it is imperative that consent is gained by the referrer to discuss the referral and signpost.

All referrals are triaged in line with the Thrive Framework and the right service is identified at that time for the young person/family. Every referral receives a plan of support to ensure that the young person receives the right support at the right time, and this is communicated back to the referrer by letter. The referral pathway is able to be accessed again where the single point of access can look what worked well and what didn’t in case the young person needs follow up support.

The information below is a navigation guide to support you in your referral decision making.

Presenting Difficulties	Criteria	Thrive Group	Intervention Types	Who Can Support	Referrals
Low Mood	Persistent low mood of at least 2 weeks in duration at a level that is impacting on daily functioning	Getting Help	Psycho Education Behavioural Activation Cognitive Behavioural Therapy Informed Solution Focused Therapy Resilience Group Support Walk-in Brief Intervention (the Hive) 1:1 Coaching Peer Support	School/ College Pastoral Team Community Hive https://www.togmind.org/youth-in-mind/the-hive Kooth.Com online Counselling https://kooth.com/	School mental health lead or safeguarding lead Self referral to Community Hive 8-18 Self referral to Kooth 10-25
Depression or Mood Disorder (including mood dysregulation)	Low mood that has not responded to “getting help interventions”, Or current presentation of Clinical Depression / Mood Disorder	Getting More Help	CBT IPT Systemic Family Practice (Family Therapy) Medication Psychotherapy	Single point of Access Mental Health Referral (MARS referral)	GP or professional referral. up to 18
Self-Harm: That is infrequent and not require medical intervention	Self-harm is when somebody intentionally damages or injures their body. It's usually a way of coping with or expressing overwhelming emotional distress	Getting Help	Psycho- Education / Distraction Techniques Counselling Guided Self Help Compassion Focused Work Solution Focused Therapy Walk-in Brief Intervention (the Hive) 1:1 Coaching	School/ College Pastoral Team Kooth .Com Community Hive https://www.togmind.org/youth-in-mind/the-hive National Self Harm Network http://www.nshn.co.uk/downloads.html Young Minds Website https://youngminds.org.uk/	School mental health lead or safeguarding lead Self referral to Community Hive 8-18 Self referral to Kooth 10-25
Self-Harm: That has become more frequent and intense Suicidal Ideation with some plans and or few protective factors and or increased identified risk factors	Where a young person has a history of self-harm and is currently harming more frequently and is as risk of significant harm N.B if the child or young person need immediate medical intervention –They will need to attend their local A and E	Getting More Help	Medical Intervention (GP/ Walk in Centre / Emergency Department A and E) Mental Health / Risk Assessment Safety Planning DBT / DBT Informed Work Psycho Education – Self Regulation Techniques	Follow Self Harm Pathway Local Medical Services https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/nhs-111/ Liaison Mental Health (LMH) for advice CAMHS Urgent / Duty Referral Complete MARS	GP or professional contact CAMHS duty team or contact SPOA depending on risk
Suicidal Thoughts	Where a young person is expressing some fleeting thoughts with no plan and has identified protective factors	Getting Help	Risk Assessment Safety Planning / Care Plan Self Help strategies – Guided Self-Help Psycho Education Solution Focused Therapy Counselling	Community Hive https://www.togmind.org/youth-in-mind/the-hive School/ College Pastoral Team Kooth.Com online Counselling Papyrus –Suicide Prevention https://papyrus-uk.org/	School mental health lead or safeguarding lead Self referral to Community Hive 8-18 Self referral to Kooth 11-25
Suicidal Ideation	Where a young person is presenting with increased and intrusive suicidal thoughts and or regular increased self-harm	Getting More Help	Mental Health / Risk Assessment Safety Planning / Care Plan Psycho Education Self-Regulation	CAMHS Urgent / Duty Referral Rapid Response Team Liaison Mental Health (LMH)
Actual Significant Self Harm or Overdose /Need for Medical Intervention	If a young person presents with significant self-harm and or has taken substances / overdosed Send to A and E immediately	Getting Risk Support	Medical Intervention Risk Assessment Safety Planning Admission	Medical Services Liaison Mental Health (LMH)
Anxiety including: Phobias Panic Disorder Social Phobia Generalised Anxiety Disorder Obsessive- Compulsive Disorder	Anxiety at a level that is affecting the child’s/young person’s development or level of functioning, over a sustained period and this is not a normal adjustment reaction to a life event / adverse event	Getting Help	Psycho Education Guided Self Help CBT informed interventions Solution Focused Therapy Walk-in Brief Intervention (The Hive) 1:1 Coaching Counselling Peer Support	Community Hive https://www.togmind.org/youth-in-mind/the-hive School/ College Pastoral Team Kooth.Com online Counselling Single Point of Entry Mental Health Referral – CYPWPs (MARS referral) With a view to accessing getting more help / getting risk support	School mental health lead or safeguarding lead Self referral to Community Hive 8-18 Self referral to Kooth 10-25 GP referral for CAMHS up to 18

Prolonged / More Frequent/ Intense Anxiety	More Intense repetitive, intrusive thoughts, greater distress, more significant impact on thoughts feelings and behaviour which affects daily life, quality of life and activity. Obsessions/Compulsions causing functional impairment	Getting More Help	CBT Family work Medication	Single Point of Access Mental Health Referral (MARS referral)
Post-Traumatic Stress Disorder (PTSD)	Avoidance of reminders of the traumatic event. Persistent anxiety. Intrusive thoughts and memories e.g. nightmares. Sleep disturbance. Hypervigilance. Symptoms continuing longer than three months following event	Getting More Help	Trauma Focused CBT EMDR	Single Point of Access Mental Health Referral (MARS referral)
Major Mental Health Difficulties / Psychosis	Active symptoms Inc. Paranoia, delusional beliefs & abnormal perceptions, (hearing voices & other hallucinations). Fixed, unusual ideas. Negative symptoms Including deterioration in self-care & social & family functioning.	Getting More Help	Extend Assessment Referral to EIT services Psycho-Ed Medication CBT	Single Point of Access (MARS referral)
Neurodevelopmental Concerns: Autistic Spectrum Conditions (ASC)	If there are concerns regarding pervasive developmental disorders such as ASD then school would complete a 12-week pre referral questionnaire before being accepted onto the MAAT (assessment) pathway Consider a referral to Community Paediatrics if your concerns are around child development.	Getting Help	Assessment Consultation Post Diagnostic Group	School complete 12-week pre referral Questionnaire School forward 12 week questionnaire plus one professional report to MAAT for triaging Pupil Support Service (specialist outreach support) to schools MAAT assessment of social communication difficulties Speech and Language assessment / Sensory workshops (Children with Disabilities Team (CWD) self referral) Community Paediatrics Support for parents Tameside Autism Network Autism service for Children MAAT parent waiting list consultation offer Parents can continue to use strategies from Strategy Document Parenting interventions e.g. Riding the Rapids MAAT post diagnostic workshops; social communication strategies document; post diagnostic pack Websites such as NAS/Cerebra https://i-am-autism.org.uk/ Autism - Local Offer Getting Risk Support – flag early concerns about potential risk of hospital admission or placement breakdown so that family is supported on the Dynamic Support Register	School to complete the pre referral questionnaire. GPs do not refer to CAMHS but may refer to paeds for a reason. GP may also raise with social worker if at risk of placement breakdown.
Attention Deficit Hyperactivity Disorder (ADHD)	If there are concerns relating to ADHD refer to Pupil Support Service to initiate the assessment process within school to gather evidence or observed behaviours in all settings (Home, School, In Clinic)	Getting Help	Assessment Medication Post Diagnostic interventions	Pupil Support Services Paediatrician ADHD (tameside.gov.uk) Single Point of Access (MARS referral)	GP or school to refer to pupil support services in the first instance
Eating Disorders	Anorexia Nervosa / Bulimia Nervosa, Binge Eating Disorder Please include recent Bloods weight/height and rate of weight change	Getting More Help	Family Based Treatment, Specialist Family Therapy for Anorexia / Bulimia Nervosa, Adolescent Focused Therapy, CBT, Physical Monitoring, Community Re-feeding,	CEDS Community Eating Disorders	GP or professional or family referral to CEDS
Behavioural Problems	Where there are difficulties in the family’s daily living: - such as family conflict, difficulty setting routines and boundaries for mealtimes, homework, sleep, school, and house hold rules, social difficulties, parents and other family members needing carer support	Getting Help	Parenting Courses/ Groups, Psycho- Education Early Help GP for parental health and wellbeing Family Work Walk in Brief Intervention (The Hive) 1:1 Coaching	Early Help Access Point Parenting Team Solihull Online www.inourplace.co.uk (password Sunflower) Families in Mind at Community Hive https://www.togmind.org/youth-in-mind/the-hive	GP or professional referral to Early Help via MARS Self refer to Parenting, Solihull or Family Support
Persistent and Pervasive Behavioural Problems	Where the presentation is indicative of Conduct Disorder, and or Attachment Difficulties. This would include persistent and repetitive patterns of challenging behaviours, which are not in the context of an Autistic Spectrum Condition, Learning Disability and/or explained by another medical condition or social circumstance. For example, ADHD or social deprivation. Plus the nature and degree of the behavioural problems have a significant impact on daily functioning and the social and emotional development of the child.	Getting More Help	Parent Interventions Family Therapy Parent Child Game VIG Multi Systemic Therapy	Single Point of Access Mental Health Referral N.B A first line intervention e.g. parenting course and or an early help intervention should have been tried before referring to mental health Multi Systemic Therapy Via Social Worker Helping at Home Early Attachment consultation Consultation from Family Intervention service	GP or professional referral to Early Attachment Service up to age 5 GP referral to Early Help
Complex Behavioural Problems / Emotional Dysregulation	Children and Young People unable to benefit from or engage with recommended interventions but remain a significant concern or risk, including those who routinely go into crisis or don’t/ Can’t make use of help	Getting Risk Support	Liaison with the network to develop a multiagency shared care Risk Assessment and management plan Actions include Calling for and attending Social Care Strategy Meetings, Child Protection Conferences, Edge of Care Meeting, School / College Safeguarding / Fitness to Learn Meetings, Police Silver and Gold Strategy Meetings, CAMHS Risk Assessment Management Meetings (RAMM), In-patient Emergency Admissions and Discharge Meetings.	All Services / Providers Share Responsibility for getting a Child or Young Person Risk Support Getting Risk Support it is a multiagency / multidisciplinary approach. We are all responsible for the safety of the children and young people we see, therefore all services / professionals need to be involved in the development of a cross agency multi-disciplinary risk plan, working in conjunction with the child / young person and their family/carers / support networks. Including: Social Care, Police, Ambulance and Fire Services, Accident and Emergency Departments, Schools, Collages, 3rd / Voluntary Sector, Crisis Support Services, Liaison Mental Health, Home Treatment Teams, GP, Community Nurses, Safeguarding Practitioners, 111, Crisis Help Line Providers, Early Help Hub, Youth Workers, CAMHS etc. Team Around Approach Family Intervention Team Flag to the DSR (LDA / plus other presentations can be discussed)
Mild / Moderate / Severe / Profound Learning Disability Presenting with Behaviour that Challenges	If there are concerns regarding a child or young person with an identified learning disability having a change in behaviour which could be indicative of a mental health difficulty, or difficulties in the family’s daily living where parents need support	Getting Help	Parenting Courses/ Groups, Psycho- Education Early Help GP for parental health and wellbeing Family Work Walk in Brief Intervention (The Hive) 1:1 Coaching SENDIAS to support with education Psychology or LD nurse consultation Short term interventions Initial assessment, risk assessment and formulation via CAMHS LD Consideration whether LD CAMHS/generic CAMHS most appropriate service Signposting and liaison Use of GBO Multi-agency meetings	Early Help Access Point Parenting Team Families in Mind at Community Hive https://www.togmind.org/youth-in-mind/the-hive www.inourplace.co.uk (password Sunflower) Websites for signposting CAMHS LD team	GP or professional referral to Early Help Self referral to Community Hive
Mild/ Moderate/ Severe / Profound Learning Disability Presenting with Persistent and Pervasive Behaviour that Challenges	Mild – moderate learning disability as above for individual mental health conditions as managed by core CAMHS team Severe – profound learning disability	Getting More Help	Parent Interventions Registering (with family consent) with Dynamic Risk Register Longer term interventions e.g. functional analysis of challenging behaviour Pharmacotherapy Evidence based treatment approaches (family therapy, adapted CBT, narrative approaches) Ongoing risk monitoring and input into multi-agency planning	Face to face parenting interventions e.g. Riding the Rapids (via Parenting Panel/CAMHS) Single Point of Access Mental Health Referral Child and Adolescent Behaviour Service (CABS), Children with Disabilities Team (CWD) Individualised Commissioning (Dynamic Support Register)	GP or professional referral to Single Point of Access

Mild / moderate / severe / profound learning disability presenting with complex behaviour that challenges

Children and Young People unable to benefit from or engage with recommended interventions but remain a significant concern or risk, including those who routinely go into crisis or don’t/ Can’t make use of help

Getting Risk Support

Liaison with the network to develop a multiagency shared care Risk Assessment and management plan Actions include Calling for and attending Social Care Strategy Meetings, Child Protection Conferences, Edge of Care Meeting, School / College Safeguarding / Fitness to Learn Meetings, Police Silver and Gold Strategy Meetings, CAMHS Risk Assessment Management Meetings (RAMM), In-patient Emergency Admissions and Discharge Meetings.

All Services / Providers Share Responsibility for getting a Child or Young Person Risk Support
Getting Risk Support it is a multiagency / multidisciplinary approach. We are all responsible for the safety of the children and young people we see, therefore all services / professionals need to be involved in the development of a cross agency multi-disciplinary risk plan, working in conjunction with the child / young person and their family/carers / support networks.
Including: Social Care, Police, Ambulance and Fire Services, Accident and Emergency Departments, Schools, Collages, 3rd / Voluntary Sector, Crisis Support Services, Liaison Mental Health, Home Treatment Teams, GP, Community Nurses, Safeguarding Practitioners, 111, Crisis Help Line Providers, Early Help Hub, Youth Workers, CAMHS etc.

Team Around Approach
Family Intervention Team

Dynamic Risk Register and CETR process

The range of services in the community offer to support with Getting Advice or Getting Help can be found on the following links:
Mental Health Support
TOG MIND/COMMUNITY OFFER

Other useful pages:
Local offer

Contacts and Referral Details

THE HIVE/TOG Mind & 42nd Street Community Offer – brief intervention walk in appointments
CAMHS single point of access – MARS referral direct from GP system or https://secure.tameside.gov.uk/forms/mars/f1312mars.asp
Early Help - MARS referral direct from GP system or https://secure.tameside.gov.uk/forms/mars/f1312mars.asp
CEDS – Tel: 0161 716 4060 Email: pcn-tr.ceds@nhs.net