What are the criteria for referring a child or young person with depression to specialist mental health services?

Referral to tier 2 or 3 CAMHS is indicated for children and young people with:

• Moderate or severe depression (including psychotic depression) ².
• Signs of a recurrence of depression in those who have recovered from previous moderate or severe depression ².
• Unexplained self-neglect of at least 1 month's duration that could be harmful to their physical health ².
• Active suicidal ideas or plans ².
• Depression with 2 or more other risk factors for depression ¹.
• Depression where 1 or more family members have multiple-risk histories for depression ¹.
• Depression in children and young people who have not responded to interventions in tier 1 after 2–3 months ¹.

Referral to tier 4 services is indicated for:

• Children and young people at high recurrent risk of acts of self-harm or suicide ².
• Children and young people with significant ongoing self-neglect that could be harmful to their physical health ².
• Children and young people who require a level of assessment, treatment, or supervision not available in tiers 2 or 3 ².