Getting help, or making a referral: a guide for teachers.

The first thing you may want to do is to ask yourself what kind of problem you are addressing. For example:

Autism spectrum disorder, attention deficit hyperactivity disorder, learning disability.

All of these need specialist help and it is important to obtain a diagnosis to obtain such help and possible associated funding. You might obtain support for this from: the educational psychology service, the child and adolescent mental health service (CAMHS), Community Paediatrics, an independent child and adolescent psychiatrist, Primary Mental Health Workers, or in due course, the proposed schools mental health support teams.

Suspected mental health problems other than the above, for example, depression and anxiety in any of its various forms. Including trauma-related effects from outside events, possibly from outside events that we may not know about.

Any of the above may be relevant, or specialists in 'talking therapies' such as counsellors, clinical psychologists, counselling psychologists, school nurses, or IAPT Services.

'Badly behaved’ in school, but with no particular mental health problem.

Appropriate help here may be obtained from your colleagues, either informally or formally, or from the educational psychology service, although you would have to be confident that there wasn’t some underlying cause of the behaviour.

How to contact the specialists named.

With the below, some will accept referrals from schools or even self-referrals from family, others require a GP or perhaps school nurse referral. It may vary locally.

General practitioner. A GP is often a very good resource in that GPs tend to know who is available locally and what their strengths and weaknesses are. Sometimes there is one GP in a practice who has a particular interest in mental health, and it may be worth identifying that person. A complicating factor for teachers is that you do not typically have direct access to the young person's GP.

Child and adolescent mental health service (CAMHS). Contact details can be found by searching online for your local CAMHS. A complicating factor is that many CAMHS have a long waiting list and are often overstretched.

Primary Mental Health Workers. Are based in CAMHS but work with schools and others to support young people’s mental health. They may offer consultation around a child’s difficulties or advice on where best to refer.

‘Community Paediatrics’. Contact details can be found by searching online for your local Community Paediatric facility.

Independent child and adolescent psychiatrist. A good starting point is to ask your local CAMHS if they know of an independent child and adolescent psychiatrist (if the CAMHS waiting list is too long) or to contact an independent healthcare provider (Nuffield, Spire, etc) as many such providers will offer psychiatric services. Also to search online for 'child and adolescent mental health services' and see what independent providers appear: there are sometimes independent ‘co-operatives’ of psychiatrist, psychologists, nurses, etc.

Independent clinical psychologist, counselling psychologist, counsellors. As above, always being aware that the professional should have a specialist interest in children and adolescents.

IAPT Services (Improving Access to Psychological Therapies). Through a GP Practice or search online. Often, IAPT Services will only treat people over 16 or 18, but sometimes there is a IAPT for younger people.

Any others that you can bring to mind locally. For example the local Social Care Early Help offer. (Search your Local Authority Social Services Early Help, e.g. ‘Leicester Social Services Early Help’.)

Confidentiality.

Young people are entitled to confidentiality as much as anyone else, but, if you have legitimate concerns about their welfare – or the welfare of others – you may be entitled to breach that confidentiality.

Under 16s are presumed not to be competent to make decisions about their treatment unless they are assessed to be Gillick competent (search online if relevant).

Safeguarding.

Safeguarding is defined in Working together to safeguard children 2013 as:

protecting children from maltreatment
preventing impairment of children’s health and development
ensuring that children grow up in circumstances consistent with the provision of safe and effective care and
taking action to enable all children to have the best outcomes.

What to do if you’re worried a child is being abused.

What to do if you’re worried a child is being abused is an excellent (England-based) document which answers exactly the question it poses. It can be accessed by searching online for the title.

Safeguarding is a term which is broader than ‘child protection’ and relates to the welfare of children and protecting them from harm. Safeguarding is everyone’s responsibility.

Many serious case reviews focus on the lack of communication and information-sharing. We respect client confidentiality and yet the child’s safety is paramount.

When you have safeguarding concerns you should contact your safeguarding lead, your manager, the children’s social services duty team or, with serious immediate concerns, the police.