Multi-Agency Working

Working with CAMHS: A Guide for Social Workers

January 2025•12 min read

Understanding CAMHS

Child and Adolescent Mental Health Services (CAMHS) provide specialist mental health support for children and young people up to age 18. Understanding how CAMHS works helps you access appropriate support for children on your caseload.

CAMHS is often described in tiers, though many areas now use a different model focused on need rather than service level.

CAMHS Tiers Explained

Tier 1 - Universal Services

  • GPs, schools, health visitors
  • Early identification and support
  • Basic mental health awareness

Tier 2 - Targeted Services

  • School counsellors, primary mental health workers
  • Mild to moderate difficulties
  • Often provided in community settings

Tier 3 - Specialist CAMHS

  • Multi-disciplinary teams
  • Moderate to severe difficulties
  • Assessment, diagnosis, treatment
  • Usually clinic-based

Tier 4 - Inpatient/Highly Specialist

  • Hospital admission
  • Severe mental health crises
  • Specialist eating disorder units
  • Secure mental health provision

Important: Many children known to social care have significant mental health needs, but may struggle to access CAMHS due to waiting times or thresholds. Understanding the system helps you advocate effectively.

Making CAMHS Referrals

Information to Include

  • Clear description of mental health concerns
  • Impact on daily functioning
  • Duration and severity of symptoms
  • Risk factors (self-harm, suicidal ideation)
  • Previous interventions tried
  • Family history of mental health
  • Current living situation and stability

Common Reasons for Rejection

  • Presenting issues are behavioural not mental health
  • Placement instability affecting engagement
  • Need for trauma work before therapy
  • Parental consent issues
  • Incomplete referral information

Document Mental Health Observations

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Looked After Children and CAMHS

Specific Challenges

  • High rates of mental health need
  • Placement moves disrupting treatment
  • Difficulties engaging with services
  • Complex trauma histories
  • Consent and parental responsibility issues

Specialist LAC CAMHS

Many areas have dedicated CAMHS for looked after children:

  • Lower thresholds for acceptance
  • Understanding of care system
  • Flexibility with appointments
  • Consultation for professionals
  • Support with placement stability

Joint Working

Information Sharing

  • Share relevant safeguarding information
  • Provide context about family circumstances
  • Update on placement changes
  • Coordinate around appointments

Attending Appointments

Consider attending CAMHS appointments to:

  • Provide historical information
  • Support the young person
  • Understand recommendations
  • Coordinate care plans

CPA Meetings

Care Programme Approach meetings for complex cases:

  • Multi-agency care planning
  • Review of treatment progress
  • Coordination of support
  • Social workers should attend for LAC

Crisis Situations

Mental Health Crisis

If a child is in mental health crisis:

  • Contact CAMHS crisis team if available
  • A&E for immediate risk to life
  • Stay with the young person
  • Remove means of self-harm if safe
  • Contact emergency services if needed

Section 136

Police power to take someone to a place of safety:

  • Used when person appears mentally unwell in public
  • For assessment, not treatment
  • Social worker should be informed for children
  • Can lead to Mental Health Act assessment

Supporting Mental Health

While Waiting for CAMHS

  • Ensure placement stability where possible
  • Consider school-based counselling
  • Support carers to understand needs
  • Monitor for deterioration
  • Re-refer or escalate if needed

General Support

  • Consistent, reliable relationships
  • Predictable routines
  • Physical health and activity
  • Educational engagement
  • Opportunities for positive experiences

Common Challenges

Long Waiting Times

  • Document ongoing concerns
  • Request updates on waiting list position
  • Escalate if risk increases
  • Explore alternative support meanwhile

Thresholds and Rejection

  • Challenge decisions with evidence
  • Provide additional information
  • Request consultation instead of treatment
  • Escalate through managers if needed

Conclusion

Effective partnership with CAMHS is essential for supporting children's mental health. Understand the system, make strong referrals, and advocate persistently for children who need specialist support. Your ongoing relationship with the child complements what CAMHS provides.