Referral criteria

We would expect a child or young person to have several of the factors listed below to be considered appropriate for a referral to CAMHS. These factors need to be considered in the context of the child or young person’s age and their stage of development. You should include details about them in your referral. 

Once we receive a referral, our clinicians will use this information, along with their clinical experience and judgement to decide if support from our mental health services is needed. If so, the child or young person will then be offered a choice of appointment during which an assessment will be completed.


  • Self-harm behaviour (increasing frequency, unsafe methods, intent to harm, few coping strategies, lack of resilience)
  • Harm to others
  • Suicide ideation; intent to end life, plan in place, little or no protective factors, means to carry out plan, previous attempts
  • Misuse of substances impacting on safety and functioning of the child/young person
  • Engaging with risky/harmful sexual activities
  • Harmful use of social media which is negatively impacting on emotional/mental health


Health needs

  • Increased or reduced appetite
  • Concerning changes in sleep pattern
  • Concerning changes in weight
  • Concerning eating habits
  • Excessive exercise
  • Increased physical symptoms which may be psychosomatic (headaches, stomach aches etc with no other explanation)
  • Worsening of diagnosed chronic health conditions (with no other explanation)
  • Onset of acute physical illness
  • Co-morbidities e.g  autism spectrum disorder/attention deficit hyperactivity disorder/tics/tourettes/intellectual disability



  • Distorted thought patterns
  • Acting on intrusive thoughts
  • Increasing level of distress from intrusive thoughts
  • Unhelpful thoughts which impact on the ability to function
  • Flashbacks



  • Irritability
  • Aggression
  • Withdrawn
  • Isolating
  • Manic
  • Low
  • Tearful
  • Over-sensitive
  • Difficulty with controlling emotions

(Outside of usual development of the individual child/young person and current circumstances)


Impact on education and learning

  • Attendance dropping
  • Persistent absences/truanting
  • Attainment changing
  • Change in motivation/lack of engagement
  • Change of concentration level
  • Behaviour pattern changing (withdrawal/challenging etc)


Impact on social relationships

  • Changes in friendship groups
  • Bullying behaviour
  • Subject of bullying
  • Change in quality of friendships
  • Loss or bereavement
  • Engaging with inappropriate relationships


Impact on social functioning

  • Decreased enjoyment of previously enjoyed activities and/or interests
  • Withdrawal from activities
  • Lack of engagement
  • Change in self-care skills (change in how they dress/present themselves)
  • Offending behaviour/persistent anti-social behaviour
  • Over-familiar/over-friendly


Impact on family functioning and relationships

  • Withdrawing from family members
  • Needing to have more contact with family members than before
  • Increased arguments/conflict
  • Concerns regarding parenting ability/lack of parent support/comfort
  • Excessive reassurance seeking from child/young person
  • Change in family activities
  • Change in family set up/dynamics
  • Loss or bereavement 
  • Mental and physical health of family members which may impact on the young person


Previous support/involvement from other agencies

If the child or young person has been having difficulties for some time and has already receveied support from one of the following but the problems have not improved:

  • School health service involvement
  • Student support within school
  • Family service intervention
  • Private/voluntary counselling
  • School counselling
  • Domestic abuse services
  • Bereavement services
  • Concerning behaviours pathway
  • Relevant voluntary agencies