About CAMHS

In 1995, the government reviewed the commissioning, role and management of child and adolescent health services (‘Together We Stand’, NHS Health Advisory Service). The report recommended the adoption of 4 tiers of service. These are not rigid but serve to identify the styles and levels of specialism involved in offering comprehensive and co-ordinated services.

Tier 1 - Primary or Direct Contact Services eg GPs, schools This tier includes GPs, health visitors, generic social workers, school staff, voluntary sector workers, police and others. They are usually the first point of contact between a child and family and the childcare or health agencies. Most child and adolescent problems are managed at this level.

Tier 2 - Interventions by individual specialist CAMHS professionals eg psychologist, counsellor This tier includes work done by mental health professionals when they work individually with children and families. This work is often done at home or in schools or health centres. Often this work is relatively short-term and is concerned with specific issues.

Tier 3 - Interventions offered by teams of specialist CAMHS staff eg CFCS This tier consists of more specialist services coordinated to work with more complex problems. They can be clinic or community based eg Reframe, Early Start Child and Family Consultation Team or AMHT. Tier 3 staff assess and treat children whose mental health problems cannot be managed in Tier 2. They also act as gatekeepers to Tier 4. Often this Tier works with children, people and their families where the problems are multiple, severe and persistent.

Tier 4 - Very specialised interventions and care This tier provides for highly specific or complex problems eg psychiatric inpatient units or consultation services for those with severe eating disorders.

Communication between the different tiers is essential so that children and families receive the service which is best suited for them.

To find out more about CAMHS and how it relates to Every Child Matters, go to: http://www.everychildmatters.gov.uk/health/camhs/