The pathway draws together a range of services that work alongside mental health teams to support young people and families.
Further details about each stage of the pathway are elsewhere in this website. Information and essential resources are available to access by clicking on the links in the below:
- Prevention and early intervention from:
- Schools and education support services
- Health visitors
- School nurses
- Other universal services
- Young people, parents or carers
- Refer via Behavioural and Emotional Health website or call 0115 876 4000
- Multi-agency team screen and triage
- Information and advice
- Further planning and support from the CYP BEH Team
- Child and adolescent mental health services
- Community paediatrics
- Parenting programmes
- Universal services
- Targeted services
- Education support services
- CYP BEH Team
Transition to adulthood to be considered at every stage, as appropriate.
Consider safeguarding needs throughout.
The pathway draws together the work of current services and professionals from across Nottingham City (such as health, social care, education, youth and play, and voluntary sector services). It helps them to deliver a seamless service with positive outcomes for children and young people. The pathway does not replace current mental health services, but works alongside these services to ensure children and young people receive the most appropriate support at the earliest opportunity. If more specialist assessment or support is needed, the pathway aims to make sure this is carried out by the most appropriate service or services.
The pathway aims to:
- deliver positive outcomes for children and young people and their families;
- ensure that children and young people have their needs identified and met at the earliest opportunity;
- prevent behavioural, emotional or mental health needs escalating;
- ensure that children and young people who may be experiencing mental health issues or present with difficulties that may indicate possible ASD or ADHD have a timely assessment by the most appropriate professional.
This will be achieved by:
- identifying and addressing any concerns at the earliest opportunity;
- ensuring the right early interventions and support strategies are put in place, monitored and reviewed;
- directing referrals to the most appropriate service, which may be services provided by a range of organisations and may include referrals to more specialist services;
- managing the demand for more specialist services and reducing waiting times for interventions by supporting children and young people when their needs are emerging;
- planning and implementing ‘person-centred’ and multi-agency support;
- planning transition to adulthood and/or adult services where appropriate;
- building additional skills across the community workforce.
This guidance has been produced to support professionals working with children or young people where there are concerns about behaviour, emotional health and wellbeing, mental health issues or a neurodevelopmental problem such as Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD).
There is one referral point for this pathway for all agencies supporting children and young people with behavioural, emotional or mental health needs. This is known as the Nottingham City Single Point of Access (SPA) for children and young people with behavioural, emotional or mental health needs.
The development of the pathway for children and young people with behavioural, emotional or mental health needs was coordinated by NHS Nottingham City CCG in partnership with Nottingham University Hospitals NHS Trust, Nottinghamshire Healthcare NHS Trust, Nottingham City Council, Nottingham CityCare Partnership, voluntary sector colleagues and children and young people and their parents/carers.
Essential considerations before beginning the pathway
For professionals beginning the pathway, please ensure you can answer ‘yes’ to each of the following points before making a referral into the pathway:
- I have read the guidance notes contained in the pathway document.
- I have checked that the child or young person is registered with a Nottingham City GP.
- I have considered safeguarding needs of children and young people.
- I have checked whether a Common Assessment Framework (CAF) is in place (this can be checked with CAF central records) and raised a CAF where appropriate, or there is evidence of multi-agency meetings.
- I have appropriate consent.
- I have considered any other health needs that may need to be addressed.
- If the child or young person is of school age or below I have discussed initiating the pathway with the school nurse or health visitor (or family nurse if in place). They will make sure the pathway is documented on the child’s clinical records.
- If the young person is aged 19 to 24 with special education needs, I am aware that further discussions should be held with the Children’s & Young People’s Behavioural and Emotional Health Team (CYP BEH Team).
- I will access additional information and resources for each point of the pathway by following the links throughout this site (or if viewing a hard copy, by referring to the appendix).
- I have notified the child or young person and their parents/carers that their information will be stored on information systems at Nottingham City Council and Nottingham CityCare Partnership.
A pathway coordinator will be identified. This will be a professional from universal services who is in direct and regular contact with the child or young person. The pathway coordinator may change to the most appropriate professional over the course of the pathway dependent on the child or young person’s needs.
NHS Nottingham City Clinical Commissioning Group has commissioned a service called Children and Young People’s Behavioural and Emotional Health (CYP BEH) to support the implementation of the pathway.
This service will:
- provide training and development for professionals working with children, young people and families across Nottingham City to help them use the pathway;
- act as a contact/consultation point for advice and information to those using the pathway;
- support universal services to deliver early interventions and support strategies where appropriate;
- be integrated within the existing Nottingham City Single Point of Access (SPA) for children and young people with behavioural, emotional or mental health needs and support triage of referrals in line with the pathway;
- undertake direct work with appropriate children and young people by:
- providing parenting and family support interventions where appropriate;
- gathering further information;
- undertaking pre-assessment work that may be required prior to a specialist clinical assessment
- determining where further assessment is required;
- supporting on-going packages of care during and after any further assessment and treatment;
- delivering evidence-based interventions;
- coordinating transition to adulthood and/or adult services (where appropriate);
- working in partnership with behavioural, emotional and mental health services across Nottingham City.
The CYP BEH Team can be contacted by clicking here.
The pathway is for children and young people who:
- Present with concerns about their behaviour, emotional wellbeing or mental health
- Present with concerns about possible ASD or ADHD
- Are registered with a NHS Nottingham City GP
- Are aged 0 to 18 (the pathway extends up to the age of 24 where the young person has an Education, Health and Care Plan (EHCP)).
- Any professional working with a child or young person where there are concerns about emotional health and wellbeing, mental health issues or a neurodevelopmental problem such as ASD or ADHD.
- A child or young person or parent/carer can use the pathway by calling the Nottingham City Single Point of Access (SPA) for children and young people with behavioural, emotional or mental health needs
In order to enable sharing of information consent to use the pathway must be gained. Consent can be gained from the child or young person’s parent or carer or from the young person directly where appropriate.
Children and young people form a significant proportion of the population of Nottingham City. There are approximately 120,270 children and young people aged 0 to 24 living in Nottingham and 19,200 of these are under 5. It is estimated that around 8,500 children and young people in Nottingham have a diagnosable mental health issue, self-harm, or have Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD).
This pathway supports the recommendations from the recent review of Tier 2 and Tier 3 Child and Adolescent Mental Health Services (CAMHS) completed in Nottingham City, by strengthening the universal pathway into behavioural, emotional or mental health services.
This pathway ensures that presenting concerns about a child or young person are recognised and fully explored, and that the right support is made available at the right time and in the right place to ensure that outcomes for children and young people are improved.
The pathway is underpinned by a range of guidance and strategies including: