Stay Well On-line Referral Form
Stay Well is an emotional health and wellbeing service for children and young people experiencing mild to moderate mental distress – providing a range of group and 1-2-1 interventions.
Please note that Stay Well:
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Will only accept referrals with mild-moderate mental health concerns, we do not offer crisis support
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Does not provide assessments or diagnoses of the following conditions: ASD, ADD, ADHD or ODD (please refer to below CAMHS Single Point of Access)
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Should only be your first referral if you do not have an MHST within your school
Make a CAMHS Referral
Our service supports young people with mild to moderate mental health needs. Where a young person’s needs fall outside this level, we may recommend referral to alternative services, including specialist support such as CAMHS, to ensure they receive the most appropriate care.
This may include situations where a young person is experiencing:
- Thoughts of suicide, plans to harm themselves, or recent serious self-harm
- Significant risk to themselves or others
- Severe or rapidly worsening mental health difficulties
- Complex needs involving multiple areas (e.g. mental health alongside neurodevelopmental, medical, or social care needs)
- Those seeking assessment for ASD, ADHD, ADD or ODD
- Eating difficulties that are impacting physical health (e.g. significant weight loss or medical risk)
- Symptoms that may require psychiatric or medical assessment (e.g. psychosis, severe mood disturbance)
- Ongoing difficulties that have not improved with previous early intervention support
In urgent situations, families should seek immediate support via their GP, local crisis services, or emergency departments.
Stay Well On-line Referral Form
Stay Well is an emotional health and wellbeing service for children and young people experiencing mild to moderate mental distress – providing a range of group and 1-2-1 interventions.
Referrals are accepted for children and young people:
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Aged between 5 to 18 years (up to 25 with SEND or care leaver)
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Who are experiencing anxiety, low mood, low self-esteem, difficult emotions and grief
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With a Staffordshire postcode, (home or GP, excluding Stoke-on-Trent)
For children and young people who are in Stoke-on-Trent – please visit here for more information – unfortunately, we cannot accept your referral through this on-line referral.
Before proceeding with the referral, you must have consent from either the child or young person, or from a person with parental responsibility.
You must also have the child or young persons NHS number. One of the easiest ways to find your NHS number is online, all you need is your name, address and date of birth – Your NHS number can be sent to you via text, email or letter – visit here. You can also find your NHS number on your prescriptions, hospital letters, hospital appointments and test results. Alternatively, you can ask at your GP
The referrer and the child or young person, or a person with parental responsibility must also be aware of how data will be handled through the referral process and beyond. This information can be found in our privacy policy.
All boxes in red must be completed.
By submitting this form you agree that you have read our privacy policy and understand in what circumstances your information may be shared with a third party.