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2 years ago

Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

General Physician

General Physician Referral FormFraser Early Psychosis Intervention ProgramFax to EPI Intake:Fraser South Fraser North Fraser EastFax: 604-538-4277 Fax: 604-520-4871 Fax: 604-851-4826White Rock Burnaby ChilliwackSurrey Tri-Cities AbbotsfordDelta Maple Ridge MissionLangley New Westminster Hope and AgassizPh: 604-538-4278 Ph: 604-777-8386 Ph: 1-866-870-7847Referral Date: __________________Family Doctor: _______________________ Billing No._________________________________Tel. No._______________Address:_________________________________________________Client Information:No prior treatment for psychosis.Client is 13-30 years oldClient’s Legal Name:______________________________________Date of Birth:____________(dd/mm/yy)M F PHN: ________________ Client Telephone No.________________________Client Address: _________________________________________________________________Next of Kin: ____________________________________________Client aware of referralCurrent Medication______________________________________________________________Referral information: Relevant history/ presenting problems/ known risks

Child and Youth Crisis ProgramProgram DescriptionThe Child and Youth Crisis Program(CYCP) is a collaborative initiativebetween Fraser Health and theMinistry of Children and FamilyDevelopment, serving children, youthand their families living in the FraserHealth region.CYCP provides crisis response to childrenand youth between 6-18 years of agewho are in an acute mental health crisis.These children or youth may displaybehaviours, thoughts and feelings thatare considered by the individual, familyor others to be markedly different fromtheir normal state and which seriouslyinterfere with their activities of dailyliving.These behaviours, thoughts or feelingsmay include suicidal/homicidal ideation,changes in mood, symptoms ofpsychosis, and/or self-injuriousbehaviour, which may or may not beinduced by substance misuse.Services ProvidedThe CYCP provides assessment, briefcrisis intervention and resourcecoordination including a referral toother relevant agencies when required.The crisis clinician will assess andintervene with the child or youth andtheir family as soon after the initialreferral as possible. CYCP is able tooffer up to six subsequent follow-upsessions with the child or youth andtheir family.In addition, following an assessment byCYCP, if further psychiatric consultationis required, arrangements can be madefor the child or youth to see apsychiatrist through the program.Referral ProcessReferrals to the Child & Youth Crisis Programare made by telephone.At the time of initial referral, basicdemographics, presenting problem(s) andrelevant collateral information will begathered. If the referral does not meet theprogram mandate, possible alternate referralsources can be discussed.If the referral is appropriate and telephoneresolution does not occur, the crisis clinicianwill meet with the child or youth and theirfamily as soon as possible.When possible, the child or youth and theirfamily will be seen in their own communityor at a mutually agreed upon, safe location.CYCP currently acceptsprofessional referrals only

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    MOA TasksTools/ResoucesMH Screening

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    Child/Parent or Youth:Child and You

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    WEISS FUNCTIONAL IMPAIRMENT RATING

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    Psychotherapeutic Support for Teens

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    Worry Reducing PrescriptionThere ar

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    DSM-IV Multi-axial SystemPsychiatri

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    CBIS Lifestyle SkillsHealthy Habits

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    IT’S TRUE: YOU ARE WHAT YOU EAT!

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    CBIS MANUAL | ADOLESCENT VERSION |

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    Patient Name:Date of Birth:Physicia

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    Have Trouble Getting Up in the Morn

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    2Child: Um. Lots of things I guess.

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    4For children who have worries abou

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    Patient Name:Date of Birth:Physicia

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    Reason for ReferralReferred by: Pho

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    Patient Name:Date of Birth:Physicia

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    Functioning and Lifestyle Evaluatio

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    Functioning at School (if not at sc

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    MENTAL STATUS EXAMINATION (clinical

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    Treatment PlanPatient Name: _______

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    PSP Child and Youth Mental Health -

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    Collaborative Prescribing Agreement

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    Referral FlagsReferral of the child

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    6 - item KADS scoring:In every item

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    Permission to use the KADSThe KADS

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    CHALLENGE NEGATIVE THINKINGQuestion

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    2HOW TO DO IT!Step 1: Teach younger

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    It is ver y useful to help a child

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    CBIS Cognition SkillsAnti-Depressio

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    Small GoalsThe concentration, fatig

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    Problem SolvingDepression can make

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    Thought StoppingDepression often ma

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    Referral FlagsReferral of the teen

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    SCARED - Child VersionPg. 1 of 3 (T

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    SCARED Scoring - This page is for o

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    CY-BOCS Symptom ChecklistChildren

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    RESOURCES.RESULTS.RELIEF.© Anxiety

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    CBIS ToolsIntroduction toRelaxation

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    Abdominal/Belly BreathingPurpose•

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    PurposeGroundingGrounding is a calm

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    CBIS MANUAL | ADOLESCENT VERSION |

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    MindfulnessMindfulness originally c

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    ThoughtsMindfulness Meditation• A

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    For teens: Although you should enco

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    This STOP Plan is for:_____________

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