Presentations

Suitable presentations

In a school environment, some presenting examples may look like but are not limited to:

• Specific Anxieties around transition between year groups, developing and maintaining relationships, fear of failure, low self-esteem, social anxiety, etc.

• Phobias animals/insects, specific food stuffs, specific objects, modes of transport, etc. (Excluding needle or vomit)

• Low mood age 11+

• Emotional regulation, which is not due to difficult social circumstances, social communication difficulties like ASD/ADHD and/or speech & language processing needs such as dyslexia

• Signs of repetitive behaviours linked to anxiety

• Behavioural difficulties age 5-9yrs

If the child/young person does not meet the criteria to be supported by the MHST then advice and information will be given to the school/college’s MHL about other support and services that may be available to them through onward referrals signposting.

Each area team keeps an up-to-date list of places to signpost to. To facilitate the transition to another service, MHSTs (with consent of the P/C and/or CYP), may support the referral of the CYP to another service. A directory of local services has been compiled by each MHST and is available within each team’s Shared Drive. Provision of appropriate local services (including Third Sector/charities) will vary between the MHST sites. Regular reviews are conducted to ensure our service directory is up to date and services added/removed as and when required. If signposting occurs before a referral has been submitted, then it should be recorded as Function 3

Unsuitable presentations

Presenting concerns, the MHST may not be able to support would be ones where:

• The complexity of the case is judged to exceed ‘mild to moderate’ need.

• The complexity of the case is judged to be unsuitable for the interventions offered.

• There are long-term complexities involved or current and ongoing contextual factors or difficulties (e.g. a history of significant domestic violence and/or Children’s Services support, family safeguarding concerns or if significant developmental trauma is suspected).

• The referral meets the eligibility criteria for another service and there is evidence that a better outcome will be achieved by this service. In this situation Signposting or an onward referral will be offered.

• The child/young person or parent/carer is actively using alcohol or elicit substances.

When substance misuse is identified as the main presenting problem then signposting to drug and alcohol services will be offered. If the child/young person or parent/carer is identified as using substances socially (e.g. not regular use) then an intervention may be offered after discussion in supervision and if the child/young person or parent/carer does not attend sessions under the influence of any substances.

Examples

Examples of unsuitable or high-risk cases may include:

• Behavioural difficulties above the age of 9 or that feature child/young person on parent abuse, either verbal or physical

• Self-harm as the primary presenting issue

• Post-Traumatic Stress Disorder (PTSD)

• Suicidal ideation with history of attempts and/or future/actions identified

• Biological symptoms of depression in combination with any of the above

If a child/young person has needs which are assessed to be greater than our service can meet, we will work together with school/college to attempt to find an appropriate alternative. For example, we may have a role in supporting school professionals with referrals to Single Point of Access (SPA) or any other suitable/appropriate provision.