Referral, consent and confidentiality
Children's mental health needs, in the broadest sense, are met by a multitude of people – first, and most obviously, by their parents, other relatives and friends, but also by a variety of professionals, ranging from teachers and health visitors to child psychiatrists and child psychologists. This chapter provides a discussion on fourfold division of the providers for children's mental health. Tier 1 is the 'front line' of services, involving professionals who are not primarily child mental health workers but who nevertheless deal with many child mental health problems very effectively. Tier 2 is defined as including any child mental health professional when they are working in isolation. The same individuals may also work in specialist teams, which are defined as tier 3, and usually cover only a limited geographical area. By contrast, tier 4 consists of specialised services taking referrals from a large geographical area.