Child & Youth Mental Health Algorithm - GPSC

Referral FlagsReferral of the child with an anxiety disorder to specialty mental health services can occur atthree different points. The following referral points are suggestions only. Each first contact careprovider must identify their own comfort level with treatment and management of childhoodanxiety disorders and act accordingly. These suggestions are:Emergency Referral (prior to treatment initiation by first contact care provider):Suicidal ideation with intent or suicide planMajor depressive episode with psychosis (presence of delusions and/or hallucinations)Presence of delusions or hallucinationsUrgent Referral (treatment may be initiated but referral should be made concurrently):Symptoms severe and function significantly deteriorated (e.g. severe OCD, severe panic)Relapse from previous positive treatment responsePersistent suicidal ideation with no intent or suicide planComorbid major depressive episode or family history of Bipolar DisorderHistory of suicide attemptsHypomaniaUsual Referral:Referral for Cognitive Behavioural Therapy if availablePersistent school avoidanceAnxiety disorder not responding to adequate first contact treatment trial