CAMHS — Child and Adolescent Mental Health Services — is the NHS service that assesses and treats mental health difficulties in children and young people up to age 18. When a secondary school has significant concerns about a pupil's mental health, it may support a referral to CAMHS. Understanding how this system works helps parents navigate what follows.
What does CAMHS treat?
CAMHS services assess and treat a wide range of mental health and neurodevelopmental conditions in children and young people, including:
- Anxiety disorders (generalised anxiety, social anxiety, panic disorder, phobias)
- Depression and low mood
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Eating disorders (anorexia, bulimia, ARFID)
- Self-harm and suicidal ideation
- Attention deficit hyperactivity disorder (ADHD)
- Autism spectrum conditions (assessment for diagnosis)
- Psychosis and other more serious mental health conditions
- Emotional dysregulation and attachment difficulties
Not all of these conditions fall within the same part of CAMHS — the service operates as a system of pathways, with some needs managed in community settings and more severe presentations managed by specialist or inpatient services.
How does a school referral to CAMHS work?
The referral pathway varies by local area, but the most common routes are:
| Route | Process | Used when |
|---|---|---|
| Via the GP | Parent takes child to GP → GP makes the referral | The most common and often fastest route |
| Via the school SENCO | SENCO contacts CAMHS or completes an Early Help Assessment | When educational needs and mental health needs are linked |
| Via a school-based professional | Mental Health Support Team (MHST) worker or school counsellor escalates to CAMHS | When in-school support has been tried but is insufficient |
| Self-referral (some areas) | Young person or parent contacts CAMHS directly | Available in some areas, particularly for young people aged 16 and above |
In most areas, schools cannot refer directly to CAMHS without involving the GP or completing an Early Help process first. If the school is concerned about your child, the most reliable step is to make an appointment with your GP and explain the school's concerns alongside your own observations.
What happens at an initial CAMHS appointment?
The initial CAMHS appointment is an assessment — it is not a therapy session. Its purpose is to gather enough information to understand the nature and severity of the young person's difficulties and decide what support, if any, CAMHS can offer.
A typical initial assessment will include:
- A meeting with the parent or carer (often separately from the young person) to gather background history
- A meeting with the young person themselves, usually with a CAMHS practitioner (often a nurse or psychologist)
- Completion of standardised questionnaires about mood, anxiety, or specific symptoms
- A review of any information the school or GP has provided
At the end of the assessment process (which may take one or two appointments), the CAMHS team will decide whether the young person meets the threshold for CAMHS involvement, and if so, recommend a treatment approach — which might include therapy (CBT, family therapy, or another modality), medication, or a diagnostic assessment.
What are CAMHS waiting times like?
Waiting times for CAMHS are one of the most significant challenges facing families seeking support. Across England, waiting times from GP referral to first CAMHS appointment have historically ranged from a few weeks in some areas to 12 to 18 months in others, with some families waiting even longer.
If you are concerned about the wait or believe your child's needs are urgent:
- Speak to your GP about the urgency of the referral — GPs can mark a referral as urgent or contact CAMHS directly if there is immediate risk
- Contact your local CAMHS to ask about the current waiting time and whether there is a duty line for urgent concerns
- Ask whether school-based support is available — Mental Health Support Teams (MHSTs) in schools provide short-term intervention while families wait for CAMHS
- Contact a crisis helpline if your child is in immediate distress: Childline (0800 1111), the Samaritans (116 123), or in a medical emergency, attend A&E or call 999
What support can schools provide while waiting for CAMHS?
Schools have their own mental health and pastoral support systems that can be activated while a CAMHS referral is pending:
- School counsellor — provides short-term, non-clinical counselling within the school setting; does not require a CAMHS referral
- Pastoral team (head of year, form tutor) — can monitor wellbeing, adjust workload pressure, and maintain daily contact
- Mental Health Support Team (MHST) — where available in school, offers evidence-based brief interventions for mild-to-moderate mental health difficulties, working closely with CAMHS
- Reduced timetable — if attending school full time is causing acute distress, a temporary reduced timetable may be agreed between school, family, and the local authority
Schools should not simply wait for a CAMHS appointment to begin supporting a pupil — they have pastoral and SEND responsibilities that apply regardless.
Frequently asked questions
Can a school refer a child to CAMHS without the parents' knowledge?
No. Parents must be involved and give consent for a child under 16 to be referred to CAMHS. In most areas, parental consent is required for the referral to proceed. For young people aged 16 and above, they may in some circumstances seek help independently — but this is the exception rather than the rule in practice. Schools should always be transparent with parents about their concerns and their plans.
What is the difference between CAMHS and a school counsellor?
A school counsellor is a trained counselling professional employed by the school, providing short-term support for mild-to-moderate emotional difficulties. CAMHS is an NHS clinical service for more serious or complex mental health conditions requiring clinical assessment or treatment. School counsellors do not diagnose conditions, prescribe medication, or provide the specialist therapies (such as CBT, EMDR, or family therapy) that CAMHS offers. For many young people, school counselling is sufficient; CAMHS is needed when difficulties are more clinical in nature.
My child has been assessed by CAMHS and discharged — what does that mean?
Being discharged from CAMHS means the team has assessed that your child no longer needs the level of support CAMHS provides. This might mean they have improved, or it might mean CAMHS has determined that their needs do not meet the threshold for continued CAMHS intervention. If you disagree with the discharge, you can ask for the decision to be reviewed, ask your GP for a second opinion, or request a re-referral if symptoms have worsened again.
What is the difference between CAMHS and IAPT (or NHS Talking Therapies)?
IAPT — Improving Access to Psychological Therapies — was rebranded as NHS Talking Therapies for anxiety and depression. It is an adult NHS service; young people under 18 are not eligible for NHS Talking Therapies and should be directed to CAMHS instead. Some areas offer specific services for young people aged 16 to 25 that bridge the gap between CAMHS (which ends at 18) and adult mental health services.
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