Mental Health Request Reasons

This section will only appear if you have selected Mental Health and Wellbeing Services. 

Please use this section to describe the Mental Health difficulties the child or young person is experiencing. 

For every box ticked below this section, there should be corresponding text, going into more detail about the difficulty indicated by the tickboxes. 

Eg. Anxiety - several panic attacks per week, appears to be in relation to attending particular classes (science, maths), presents as shortness of breath, sweating, partial impaired vision. Has been ongoing for 3-4 months. 

Providing as much detail as you can here, avoids our triaging teams needed to be in contact with follow up questions which can delay allocation of support for the child or young person. 

Please be aware that an email copy of the form, including all of the details provided will be sent to the parent and also to the child or young person if their email address has been supplied.