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The CAMHS tier system explained

Currently, Hertfordshire's emotional and wellbeing services for children and young people are commissioned through a tiered system, explained below. We are developing a new approach to emotional wellbeing services for children and young people in Hertfordshire. Called iThrive, it places an emphasis on prevention and early intervention. There's more information about iThrive here.

Tier 1 means early intervention and prevention and is provided through schools and children’s centres, health visitors, school nurses, GPs, Youth Connexions, helplines and websites for support with external factors affecting wellbeing; with general emotional wellbeing; and for online therapeutic support and self-help.

Tier 2 means early help and targeted services. Some of Hertfordshire’s targeted child and adolescent mental health services (CAMHS), Step 2, are provided by Hertfordshire Community NHS Trust. There’s information about the types of services Step 2 provide here. Support also comes through community counselling, counselling or mentoring in schools, education psychologists, education support centres, targeted youth support teams, family support and free online counselling for 10-25 year olds..

Tier 3 means specialist CAMHS, including eating disorder services. Hertfordshire’s specialist CAMHS are provided by Hertfordshire Partnership NHS University Foundation Trust (HPFT). There’s information about the types of services CAMHS provide here. Hertfordshire Community NHS Trust (HCT) provides the Positive Behaviour, Autism, Learning Disability and Mental Health Service (PALMS), a specialist multi-disciplinary approach to children and young people aged 0-19 who have a global learning disability and/or Autistic Spectrum Disorder and their families. There’s more information about PALMS here.

Tier 4 means specialised day and inpatient units, where people with more severe mental health problems can be assessed and treated. Currently this is commissioned by NHS England.