Quality statement 3: Suspected severe depression and at high risk of suicide

Quality statement

Children and young people with suspected severe depression and at high risk of suicide are assessed by CAMHS (Child and Adolescent Mental Health Services) professionals within a maximum of 24 hours of referral. If necessary, children and young people are provided with a safe place while waiting for the assessment.

Rationale

Prompt access to services is essential if children and young people are to receive the right treatment at the right time. Arrangements should be in place so that children and young people referred to CAMHS with suspected severe depression and at high risk of suicide are assessed by CAMHS professionals as an emergency, within a maximum of 24 hours of referral. Healthcare professionals who refer a child or young person to CAMHS should also ensure that, at the time of referral, they assess the need for a safe place for the child or young person until the CAMHS assessment is carried out. This should help to prevent injury or worsening of symptoms.

Quality measures

Structure

a) Evidence of local arrangements to ensure that CAMHS professionals assess all children and young people with suspected severe depression and at high risk of suicide within a maximum of 24 hours of referral.

b) Evidence of local arrangements to ensure that children and young people with suspected severe depression and at high risk of suicide who are referred to CAMHS are provided with a safe place if necessary while waiting for an assessment.

Data source: Local data collection.

Process

a) Proportion of children and young people with suspected severe depression and at high risk of suicide who are assessed by CAMHS professionals within 24 hours of referral.

Numerator – the number of people in the denominator assessed by CAMHS professionals within 24 hours of referral.

Denominator – the number of children and young people referred to CAMHS with suspected severe depression and at high risk of suicide.

Data source: Local data collection. For CAMHS, data on referral and waiting times are collected in the Child and Adolescent Mental Health Services secondary uses data set.

What the quality statement means for service providers, healthcare professionals, social care practitioners and commissioners

Service providers ensure that systems are in place for CAMHS professionals to assess all children and young people with suspected severe depression and at high risk of suicide within a maximum of 24 hours of referral. Service providers also ensure that systems are in place so that children and young people are provided with a safe place if necessary while waiting for CAMHS assessment.

CAMHS professionals assess all children and young people with suspected severe depression and at high risk of suicide within a maximum of 24 hours of referral.

Healthcare professionals and social care practitioners ensure that children and young people with suspected severe depression and at high risk of suicide who are waiting for CAMHS assessment are provided with a safe place if necessary.

Commissioners ensure that they commission CAMHS to assess all children and young people with suspected severe depression and at high risk of suicide within a maximum of 24 hours of referral. Commissioners also ensure that they commission services in which children and young people are provided with a safe place if necessary while waiting for CAMHS assessment.

What the quality statement means for patients, service users and carers

Children and young people with suspected severe depression and at high risk of suicide are assessed within a maximum of 24 hours of being referred to CAMHS (Child and Adolescent Mental Health Services). If the child or young person needs a safe place while waiting for the CAMHS assessment, this is provided.

Source guidance

Depression in children and young people (2005) NICE guideline CG28, recommendation 1.6.1.1.

Definitions of terms used in this quality statement

  • The time frame of 24 hours is based on consensus of expert opinion.

  • The provision of a safe place is based on consensus of expert opinion.

Severe depression

ICD‑10 classification of mental and behavioural disorders describes severe depression as 7 or more depressive symptoms, with or without psychotic symptoms.

Assessment

An assessment by CAMHS is likely to include but is not limited to:

  • assessment of diagnosis

  • initiation of treatment.

High risk of suicide

NICE guideline CG28 defines suicidal ideation as thoughts about suicide or of taking action to end one's own life. For the purposes of this quality standard high risk of suicide could include, but is not limited to, children and young people with current active suicidal plans or thoughts.