What are the criteria for referring a child or young person with depre

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

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

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

Referral to tier 4 services is indicated for:

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

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