Referring to Enfield CAMHS Page 1
Child and Adolescent Mental Health Service (CAMHS) offers help to children, young people and their families/carers living in Enfield. The age range is from birth up to their 18th birthday. The following guidance should be read with reference to the CAMHS Access Policy (see http://www.beh-mht.nhs.uk/gps-and-referrers/making-referrals. htm and click on CAMHS Access Referrals Page). Referrals should be made on an Early Help Form. What is CAMHS ACCESS in Enfield? Child and Adolescent Mental Health Service (CAMHS) Access is available within each of the three London boroughs of Barnet, Enfield and Haringey. There is a single point of entry in each borough for all referrals requesting a child and adolescent mental health service. Our aim is to provide a clear, consistent and transparent referral process for all children and young people in this area. We also aim to ensure appropriate communication between service providers, fostering co-working and minimising duplication of work. CAMHS ACCESS is made up of representatives from Barnet Haringey and Haringey Mental Health NHS Trust (Lead provider). Child & Adolescent Mental Health Services provide a variety of services and professionals for children and young people structured according to need. There are a number of community and clinic-based out-patient services, and an outreach team. These services/teams offer specialist assessments, interventions, consultation, and psychological therapy services to children and young people experiencing difficulties in their emotional and psychological well-being or mental health, along with their families. CAMHS ACCESS was created as a single point of entry to ensure that clients are offered the most appropriate CAMHS service as quickly as possible. Page 2
Emergencies Please note CAMHS ACCESS is not an emergency service. If you feel that a young person or a child is at risk and needs immediate or urgent medical assistance, s/he will need to go to their GP or local hospital Accident and Emergency. How do I refer? In Enfield, referrals to CAMHS are via the Early Help form if there is already multiagency involvement sent to the Administrator as part of the Single Point of Entry (SPOE) process. If CAMHS referrals are only single agency (i.e. no other agency apart from CAMHS) then referrals can be passed directly to Enfield CAMHS (Charles Babbage House, 1 Orton Grove, EN1 4TU Tel: 020 8379 2000 Fax: 020 8379 2020) on the CAMHS Access Referral Form. CAMHS ACCESS and Single Point of Entry (SPOE) are in close liaison and information is shared as appropriate. CAMHS and Early Help Referral Forms Please complete Early Help forms as fully as possible. This information will help us to quickly and accurately assess what service is the most appropriate for the young person/family you are referring. Send the completed Early Help forms after following the relevant instructions. Enfield SPOE Early Help forms (which replace CAF) are available electronically at: https://www.enfield.gov.uk/enfieldlscb/info/8/professionals_ and_volunteers/215/early_help_and_the_single_point_of_ entry_spoe (CAF team: 020 8351 1630 CAF administrator: 020 8379 2111) Page 3
What happens next? Referrals are processed on a daily basis, taking into account clinical need, and GP location. You will receive a letter advising you which team your referral has been forwarded to. This team will then write to the family/young person and to you. CAMHS Teams in Enfield CAMHS - an integrated service offered by Barnet, Enfield & Haringey Mental Health Services NHS Trust and the London Borough of Enfield s Schools, Children s Services and Leisure Department to support children/young people and their families where there is concern about emotional or behavioural difficulties. Assessment and therapy are provided to children/young people and families and a consultation service to other professionals. CAMHS works closely with colleagues in the Educational Psychology Service. CAMHS professional staff include: Child and Adolescent Psychiatrists, Child and Adolescent Psychotherapists, Family and Systemic Psychotherapists, CAMHS Practitioners, Clinical Psychologists, Specialist Nurse Therapists and Educational Psychologists. CAMHS offers help to children, young people and their families/carers living within the London Borough of Enfield. The age range is from birth up to their 18th birthday or leaving school. There are two Generic teams- Enfield North and South CAMHS Teams. Service for Adolescents and Families in Enfield (SAFE) SAFE is a service to provide rapid, community-based intervention to young people between the ages of 13 to 18 who are in need of crisis mental health support. This includes young people who have harmed themselves or who are at risk of suicide. In addition SAFE offers specialist assessment and intervention to teenagers who may be experiencing severe mental health difficulties, such as emerging psychosis. A&E psychiatric liaison teams and paediatric wards at local hospitals can refer directly to SAFE where urgent CAMHS assessment is required. Page 4
The Service for Children & Adolescents with Neurodevelopmental disorders (SCAN) - SCAN sees children/young people with severe learning disabilities and neuro-developmental disorders, who attend specials schools, where the degree of impairment is significant and coupled with mental health problems including for example, severe challenging behaviour. Referrals are primarily taken from CAMHS, SAFE, paediatricians, Special Schools and Cheviots (Enfield Children s Social Services). The Service works closely with the Child Development Team. Children s Centres Therapeutic Team (CCTT) this is a service provided by CAMHS and the Educational Psychology Service to help children under 5. This service can help with parent and child issues which may be affecting their relationship and concerns around a child s emotional/ behavioural development. Clinicians offer up to 5 sessions of brief therapeutic support which can be accessed in local Enfield Children s Centres. Health and Emotional Wellbeing Service (HEWs) for Enfield Schools this provides Tier 2 CAMHS interventions within schools who have commissioned this service.this may include brief direct therapeutic work with children, young people and their families, staff consultation and training. HEART Team (Health, Education, Access and Resource Team) this is a specialist service which offers a range of services to improve the emotional wellbeing of looked after children. These include assessments and treatments for mental health disorders, group and individual consultations for carers and professional staff, support for a therapeutic fostering project (IN-STEP) and a mental health screening project (EBH). A representative for all of the above CAMHS Services attends the SPOE each Tuesday and advises the partnership about the appropriateness of referrals to the above services. However, where a referral is received that identifies self-harm or potential severe mental health issues for a child or young person, the SPOE manager should contact CAMHS immediately for advice and should not offset the referral for early help prior to this. Page 5
Royal Free NHS Foundation Trust Specialist Eating Disorders Service provides outpatient, outreach and inpatient treatment for young people with eating disorders. An innovative intensive service has been developed to promote faster recovery and reduce relapse rates. Referral Criteria The core business of CAMHS is: the assessment and treatment of serious mental health disturbances and associated risks in young people under the age of 18 years. Most young people with mild emotional or behavioural difficulties are best served by universal services e.g. General Practitioners, schools, health visitors and community groups etc. Before making a referral to CAMHS, these other options should be considered (i.e. Tier 1 and tier 2 services). When the difficulties are complex and enduring and there is a significant impact on the young person s functioning, a direct referral to targeted community based services or specialist clinic based mental health services such as CAMHS or social care may be appropriate. The criteria for acceptance of a referral to CAMHS in terms of severity of the referring problems is gauged by considering the level of disturbance in a young person s functioning. If a referral is thought to be inappropriate for CAMHS, the Access team endeavour to explain why and make recommendations for alternative services in their communications back to referrers and families. As part of the process of clearly understanding the nature of the CAMHS referral, CAMHS Access clinicians may request further information from the referrer, or the young person or their family, or with permission of the child or young person s parents or carers, from other involved agencies. This is to ensure that the referral gets sent to the appropriate service as soon as possible, saving time for those being referred and increasing the efficiency of the Access service. If there are high levels of risk or urgency indicated in the referral a Page 6
timely response from CAMHS Access is essential to ensure patient safety. Such a response depends upon clear risk information being provided by the referrer. Problems Appropriate for CAMHS Referral Depression or Mood Disorder Self-Harm -Risks need to be clearly described Psychosis Anxiety Somatisation Disorders, Hypochondriasis, Dissociative Disorders School Refusal Eating problems Eating Disorders (Anorexia and Bulimia) Post-Traumatic Stress Disorder Obsessive Compulsive Disorder Tourette s Syndrome and Complex Tic Disorders Autistic Spectrum Disorders: In Enfield the Child Development Team assesses children under 6 and children over 6 are assessed in CAMHS. ADHD/ ADD symptoms: In Enfield the Child Development Team assesses children under 6 and children over 6 are assessed in CAMHS. Behaviour problems and Conduct Disorders Sleep difficulties Response to bereavement Severe family discord or family break-up Looked after Children (LAC) for those children resident in Enfield and under Enfield Social Services as well as adopted children who have mental health disorders. Significant learning disability with co-morbidity of enduring, severe challenging behaviour or mental health problems. Medical Conditions and Physical Disabilities where there are comorbid with mental health problems Page 7
Enuresis or Soiling-refer to CAMHS if this is secondary in origin and primary causes are ruled out Children Who May Be Helped By Other Services Cognitive assessments / Educational assessments referral to Educational Psychology Service, this referral is made by the child s school Dyspraxia can be referred to Occupational Therapy Serious concerns about the safety of a child/young person due to neglect, abuse or exploitation then you will need to refer to Children s Social Care. Substance Misuse Problems without mental health comorbidity can be referred to local Drug and Alcohol Services Learning difficulties and learning disability without comorbid mental health problems Where parents are seeking help for the behaviour of pre-school children e.g., feeding or sleeping difficulties, tantrums, then they should initially be encouraged to contact their health visitor Where parents may have concerns about a possible medical condition they should discuss with their GP a possible referral to a Consultant Paediatrician For children up to the age of 6, where there are concerns about neuro-development such as ASD, ADHD or developmental concerns, then the GP or Health Visitor may refer to the Child Development Team (CDT) If a child s parents seek assistance with their parenting they can be referred to the Parent Support Service. This Service offers help through Parent Support Advisors or via Parent Group Training Programme If school staff are concerned about a child s behaviour in school, their SENCO should consider referring to other agencies such as the Behaviour Support Service. If SENCOs are seeking help with learning and/or emotional or behavioural difficulties, then they can consult their Educational Psychologist. If the problem relates to school attendance referrals should be made to the Educational Page 8
Welfare Officer in the first instance Where parents are engaged in legal disputes around residence and contact, they should be advised to contact a Family Mediation Service through a solicitor When a compensation claim is outstanding, such as in relation to the trauma experienced due to a Road Traffic Accident, then you could advise the family that their child can be referred to CAMHS once the legal matters have been resolved Where the reason for a referral is primarily about a mentally ill parent, then the parent should be advised that they can request help for their own mental health difficulties through their GP. Parents can also refer themselves to agencies such as IAPT or MIND in Enfield. Young people aged 16 or over with mild / moderate symptoms of anxiety and depression can refer themselves to IAPT CAMHS Access clinicians can redirect these referrals to appropriate services, or referring professionals can refer direct. Contact CAMHS You can contact CAMHS ACCESS to discuss a referral on: 020 8379 2000 Referrers may call the Team Co-ordinator for the relevant service to discuss the referral (e.g. suitability or timing): North (Generic CAMHS) Team: 020 8379 2000 South (Generic CAMHS) Team: 020 8379 2000 SAFE (Adolescents & Families): 020 8379 2090 SCAN (Neuro-developmental Disorders): 020 8375 2806 HEART (Health, Education, Access and Resource Team): 020 8379 2000 Contact numbers for other specific agencies are listed on the Early Help Form. Page 9
Crisis Resolution and Home Treatment Team (CRHT) Service In a crisis, where the individual 16 year old or over, a CRHT service is available. The CRHT service provides urgent outreach, and assessment 24 hours a day, wherever the over 16s are situated e.g. GP surgery, A&E, or in their own homes. Enfield CRHT contact is 0208 702 3800. Barnet, Enfield and Haringey Mental Health NHS Trust We provide a range of mental health services to people living in the London boroughs of Barnet, Enfield and Haringey, and a range of more specialist mental health services to our core catchment area and beyond. Our aim is to improve the health and wellbeing of the people of north London and beyond. For more information about who we are and what we do please visit: www.beh-mht.nhs.uk. Referrers can also visit: www.beh-mht.nhs.uk/referrers Options Available If you d like a large print, audio, Braille or translated version then please ask us. Page 10
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You can ring for a translation Monday - Friday 9.00am - 5.00pm. Please give this number: 499942 and also for Audio, Large Print and Braille, call now on: 0800 952 0119 Produced By: Date of Publication: Page 12Review Date: Reference: Communications Team April 2016 April 2019 BE&H71