Until
recently the idea of Tier 4 specialist CAMHS was synonymous with psychiatric
inpatient provision, sometimes with day hospitals attached. Tier 4 has more
recently come to be understood as multi-faceted with multi-agency services that
can include inreach, outreach, intensive and crisis community initiatives, day
provision and therapeutic fostering. The past few years have seen innovative
approaches in assessment and treatment of this group of young people and the
development of new community focussed services. The purpose of this paper
is to present the latest information on these new developments and share with
commissioners and providers the evidence base for development of effective
services in this area. (Department
of Health - publications)