This pre-referral guideline covers behavioural or emotional problems in children from 0 -18 years of age.

Initial work-up

History

• Standard history and physical exam. Include history from parents/ caregivers regarding onset and course of symptoms and family history of similar problems.
• Consider both internalising and externalising behaviour problems, parenting skills, parental mental health, social factors, family dysfunction (e.g.abuse) school problems.Consider possibility of co-morbidities e.g. learning disabilities, developmental disorders.
• Consider administration of: PEDS Screening Tool
• If concerned about psychosis refer urgently to RCH Mental Health Services: Western CAMHS 1800-445511,or Southern Health tel 9594 1300or other regional CAMHS (Child & Adolescent Mental Health Service).

When to refer

• Significant parent concern PEDS Screening Tool 
• Problem difficult to define.
• Response to simple behavioural measures not effective.
• Medication may be considered.
• Has co-morbid symptoms that require special assessment or interventions.
• If suicidal or danger of self harm refer to Emergency Department or call the Crisis Assessment Team.  

Information needed

• Demographic data.
• Birth, developmental and medical history.
• Family and social history.
• Copies of previous mental health, language, cognitive, audiology assessments.
• Treatments: recommended and delivered.
• Response to treatment.
• Information regarding previous medication interventions.

Resources                

Raising Children Network for parents to access for evidence based interventions for simple and common problems to trial then return for review after a month 

Australian Psychology Association Finding a psychologist if preparing a mental health care plan is part of treatment either prior to or whilst waiting for a referral to a paediatrician

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Contact information

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