Appropriate referrals for a specialist Child and Adolescent Psychiatry Tertiary Service

As the Division of Child and Adolescent Psychiatry is a tertiary service, only Level 3 patients are seen. For an overview of what constitutes Level 1, 2 and 3 please see the guidelines listed below.

Level 1

• Treatment and access to mental health care at a primary care level

Level 2 (CHCs and District Hospitals)

• Acute psychotic disorders
• Acute mood and anxiety disorders
• Acute substance induced disorders
• Acute management of medically stable and suicide attempts
• Any psychiatric disorder which cannot be managed at level 1
• Any disorder which can be managed by a general psychiatrist (e.g. uncomplicated depression or ADHD)

Level 3 (DCAP or RCWMCH)

• Deal with moderate to severe or complicated psychiatric disorders needing a Child and Adolescent Psychiatrist, psychologist and MDT members
• First episode psychosis
• C & A psychiatric disorders not responding to treatment at level 2
• C & A neuropsychiatry (including complex neurodevelopmental disorders) 
• C & A consultation or liaison psychiatry
• Parent-infant mental health services
• Support services of Level 1 and level 2