Most young people experience times when their mood is low due to events going on in their lives. Some young people feel sad, lonely, down, and anxious or stressed for prolonged periods of time and this can then impact on their everyday life to the extent that they develop depression. Symptoms include:  not wanting to do things they previously enjoyed, avoiding friends and family, sleeping more or less than normal, eating more or less than normal, being irritable, upset and lonely, feeling hopeless, self critical, feeling tired all the time and perhaps wanting to self harm. Young children may present with regression in milestones, challenging behaviour or medically unexplained physical symptoms.

Initial intervention from other Tier 1/2 services (Universal and Targeted services) prior to specialist CAMHS involvement 

 Self help literature

NHS Self Help Guide Royal College of Psychiatrists

Mindful online counselling

NHS Inform

Support and intervention from pastoral support/ School counsellor or mental health support team where one is available.

Involvement of an Educational Psychologist.
Mild symptoms – monitoring by universal Tier 1/2 professionals.

Service provided by Specialist Child and Adolescent Mental Health Service –   Tier 3

Where depression persists and does not respond to interventions at tier 2, or where symptoms are such that the impact on everyday life is severe or where there are concerns about extent of self harm or suicidal thinking persists then refer to specialist CAMHS.

May be offered Cognitive Behavioural Therapy (CBT)/ behavioural/ solution
Focussed based intervention/ Systemic family practice/ psychodynamic psychotherapy/ interpersonal psychotherapy Medication although not a first line treatment may be initiated by a Consultant Child Psychiatrist, in consultation with young person, their family and other Specialist CAMHS practitioners who may be working with the young person. The GP will be informed.