{"id":3707,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/anxietycamhs\/"},"modified":"2026-10-08T13:19:14","modified_gmt":"2026-10-08T12:19:14","slug":"anxietycamhs","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/childandadolescentmentalhealthcamh\/anxietycamhs\/","title":{"rendered":"Anxiety CAMHS"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Anxiety disorders are the most common mental health disorders in children and young people.<strong><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Anxiety is a normal and common part of childhood. In most cases, feelings of anxiety are temporary, and may be triggered by a specific stressful event. For example, a young child may experience separation anxiety when starting school. In some cases, anxiety in children can become persistent and intense, interfering with their daily routines, activities, relationships, and overall wellbeing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>When anxiety causes ongoing distress or impairment, it may indicate the presence of an anxiety disorder.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\">Signs of anxiety can include:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Finding it hard to concentrate<\/li>\n\n\n\n<li>Problems sleeping or waking during the night<\/li>\n\n\n\n<li>Changes in appetite or not eating habits<\/li>\n\n\n\n<li>Becoming more angry or irritable than usual<\/li>\n\n\n\n<li>Worrying a lot or having persistent negative thoughts<\/li>\n\n\n\n<li>Feeling tense and fidgety, or using the toilet more often than usual<\/li>\n\n\n\n<li>Needing reassurance more often than usual<\/li>\n\n\n\n<li>always crying<\/li>\n\n\n\n<li>Being clingy or finding it difficult to separate from parents or carers<\/li>\n\n\n\n<li>Complaining of tummy aches, headaches, or feeling unwell<\/li>\n\n\n\n<li>Becoming withdrawn and losing interest in activities they usually enjoy<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\">Common types of anxiety include<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Specific fears or&nbsp;<a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/mental-health\/phobias\/\" target=\"_blank\" rel=\"noreferrer noopener\">phobias<\/a>: a strong fear of a particular object or situation or activity like dogs, injections, or flying.<\/li>\n\n\n\n<li>Feeling worried or anxious most of the time for no obvious reason<\/li>\n\n\n\n<li>Separation anxiety: feeling very worried or upset about being away from a parent or caregiver.<\/li>\n\n\n\n<li>Social anxiety: feeling very nervous or worried in social situations like meeting friends, taking part in activities with others or speaking in class.<\/li>\n\n\n\n<li>School-based anxiety: feeling anxious about going to school because of worries about &nbsp;\u2013friendships, bullying or schoolwork<\/li>\n\n\n\n<li>Generalised anxiety: Worrying a lot about everyday things often asking repeated \u2018what if&#8230;?\u2019 questions and needing lots of reassurance from others that things will be okay.<\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/A-guide-to-understanding-and-managing-trauma-for-children-and-young-people.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Post traumatic reactions<\/a>: feeling anxious, frightened, or distressed after experiencing or witnessing a stressful or frightening event.<\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/childandadolescentmentalhealthcamh\/obsessivecompulsivedisordercamhs\/\" target=\"_blank\" rel=\"noreferrer noopener\">Obsessive Compulsive Disorder<\/a>: experiencing unwanted worries or thoughts and feeling the need to repeat certain behaviours or routines to reduce anxiety.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Tier 2 CAMHS and Referral Guidance &#8211; <a href=\"https:\/\/services.nhslothian.scot\/camhs\/tier-teams\/\" target=\"_blank\" rel=\"noreferrer noopener\">Tier 2 Teams \u2013 Child and Adolescent Mental Health Services<\/a><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The CAMHS Tier 2 service is made up of mental health professionals called Primary Mental Health Workers (PMHWs). One team covers East, Mid and West Lothian and a second team covers Edinburgh North and South.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CAMHS Tier 2 support children and young people\u2019s mental health needs by offering an assessment through conversation with the young person and their parent\/carer, followed by individualised signposting to the most appropriate services or resources.&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">GPs can discuss potential referrals with a Tier 2 PMHW, who can advise whether Tier 2 support is appropriate or whether an assessment referral may require assessment by Tier 3 <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/childandadolescentmentalhealthcamh\/\" target=\"_blank\" rel=\"noreferrer noopener\">CAMHS<\/a> is required.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>G.K &amp; C.M &#8211; 6-10-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who can refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">GPs, school nurses, health visitors, teachers, social workers<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer to Tier 3 CAMHS<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Children and young people with persistent or severe symptoms of anxiety that significantly affect their daily functioning, should be referred to CAMHS.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Specialist CAMHS involvement should be considered when:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Anxiety is having a significant impact on the child&#8217;s development or everyday functioning or there has been a sudden deterioration.<\/li>\n\n\n\n<li>The level of anxiety appears disproportionate to the child\u2019s or family circumstances.<\/li>\n\n\n\n<li>Anxiety has a significant impact on family life or the parent \/ carer \/ child relationship.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Please describe this impact clearly in the referral.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>School attendance difficulties<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CAMHS will not accept referrals where school truancy is the only concern. Where anxiety is affecting school attendance, referrers should consult with education colleagues in the first instance.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Schools and local authority education departments have their own protocols and a range of resources like inclusion support workers, educational psychologists and behavioural support services <strong>which will need to be explored prior to making a CAMHS referral.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Physical Symptoms<\/strong><strong><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If a child is experiencing severe physical symptoms, an initial referral to a paediatrician is recommended to rule out any underlying physical health concern.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Please:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Discuss referrals with Tier 2 PMHW, if it is not clear whether an assessment by Tier 2 or Tier 3 <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/childandadolescentmentalhealthcamh\/\" target=\"_blank\" rel=\"noreferrer noopener\">CAMHS<\/a> is required<\/li>\n\n\n\n<li>Otherwise refer via SCI Gateway to CAMHS.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Please see locality based mental health information under the Resources and Links tab.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><strong>Locality based mental health information\/resources<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.edinburgh.gov.uk\/wellbeing\" target=\"_blank\" rel=\"noreferrer noopener\">Wellbeing \u2013 The City of Edinburgh Council<\/a> (Edinburgh)<\/li>\n\n\n\n<li><a href=\"https:\/\/eastspace.org.uk\/find-a-service\/?support=&amp;type=&amp;audience=young-people&amp;location=\" target=\"_blank\" rel=\"noreferrer noopener\">Eastspace | Find support<\/a> (East Lothian)<\/li>\n\n\n\n<li><a href=\"https:\/\/westspace.org.uk\/cyp\/resource\/\" target=\"_blank\" rel=\"noreferrer noopener\">West Space | Resources<\/a> (West Lothian)<\/li>\n\n\n\n<li><a href=\"https:\/\/www.mypas.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Home &#8211; MYPAS HOME<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>MYPAS&nbsp;<\/strong>(Midlothian young people\u2019s advice service includes counselling and family counselling services)<br>0131 454 0757<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">&nbsp;Helpful resources for parents and carers<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/camhs-anxiety-online-resources-parents-and-carers\/\" target=\"_blank\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/camhs-anxiety-online-resources-parents-and-carers\/\" rel=\"noreferrer noopener\">CAMHS Anxiety Online Resources: Parents and Carers \u2013 RefHelp<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Royal College of Psychiatrists have a range of resources written by mental health professionals and young people:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.rcpsych.ac.uk\/healthadvice\/parentsandyoungpeople\/youngpeople.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Overarching Mental Health Information<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.rcpsych.ac.uk\/mental-health\/parents-and-young-people\/anxiety-for-young-people\" target=\"_blank\" rel=\"noreferrer noopener\">Anxiety for Children and Young People<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.rcpsych.ac.uk\/mental-health\/parents-and-young-people\/coping-with-stress-for-young-people\" target=\"_blank\" rel=\"noreferrer noopener\">Coping with Stress for Children and Young People<\/a><br><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Recommended reading for parents would be <em>Helping Your Child with Fears and Worries: A Self-Help Guide for Parent (2019)<\/em> by Cathy Cresswell and Lucy Willets.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Self-care for parents and carers is important while supporting a child or young person in understanding and managing their mental health. Information can be found here:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.annafreud.org\/resources\/family-wellbeing\/self-care-for-parents-and-carers\/\" target=\"_blank\" rel=\"noreferrer noopener\">Anna Freud Centre \u2013 Self-care for all parents and carers information.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.parentclub.scot\/family-support-directory\" target=\"_blank\" rel=\"noreferrer noopener\">Parent Club Family Support Directory<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Helpful websites for young people:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">NHS Inform offer general information and signposting at a national level:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/mental-health\/anxiety-disorders-in-children-and-young-people\/\" target=\"_blank\" rel=\"noreferrer noopener\">Anxiety disorders in children | NHS inform<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Young minds offer information on different mental health presentations, accessing support and what it may look like, and how to support a friend if they are struggling.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.youngminds.org.uk\/young-person\/\" target=\"_blank\" rel=\"noreferrer noopener\">Young Minds: Young Person<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Self-help workbook of relaxation exercises for young people to practice:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/04\/Relaxation-Exercises-CAMHS.pdf\" data-type=\"link\" data-id=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/04\/Relaxation-Exercises-CAMHS.pdf\" target=\"_blank\" rel=\"noopener\">Relaxation Exercises Workbook<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NHS Scotland\u2019s <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/A-guide-to-understanding-and-managing-trauma-for-children-and-young-people.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">guide to understanding and managing trauma for young people<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NHS Inform\u2019s information about <a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/mental-health\/phobias\/\" target=\"_blank\" rel=\"noreferrer noopener\">phobias<\/a>.<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Anxiety disorders are the most common mental health disorders in children and young people. Anxiety is a normal and common part of childhood. In most cases, feelings of anxiety are temporary, and may be triggered by a specific stressful event. For example, a young child may experience separation anxiety when starting school. In some cases,<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3788,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[377],"class_list":["post-3707","page","type-page","status-publish","hentry","category-anxietycamhs"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/mentalhealthcamhs\/anxietycamhs\/\" rel=\"tag\">Anxiety (CAMHS)<\/a>","rttpg_excerpt":"Anxiety disorders are the most common mental health disorders in children and young people. Anxiety is a normal and common part of childhood. In most cases, feelings of anxiety are temporary, and may be triggered by a specific stressful event. For example, a young child may experience separation anxiety when starting school. In some cases,","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3707","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3707"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3707\/revisions"}],"predecessor-version":[{"id":30351,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3707\/revisions\/30351"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3788"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3707"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3707"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}