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Birmingham and Solihull Mental health NHS Foundation Trust
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The four tiers of support

Solihull has a range of services across four tiers which support children, young people and their families to be emotionally healthy, as set out below :

  • Universal Services (tier 1): these include general practitioners, primary care services, health visitors, schools and early years provision. Their role is to promote mental wellbeing, identify developmental or mental health needs that universal services cannot meet, and know what to do when this is the case.
  • Targeted Services (tier 2): these include mental health professionals working singularly rather than as part of a multi-disciplinary mental health team, often based in universal settings such as school counsellors; primary mental health workers who either work directly with children or support professionals in universal services to do so; or support roles specifically for children and young people who are more at risk of developing mental health problems such as looked after children or young offenders.
  • Specialist Services (tier 3): these are multi-disciplinary teams of mental health professionals providing a range of therapeutic interventions for children and young people who have complex, severe or persistent mental health needs.  This can also include intensive home support teams for children and young people at risk of admission to in-patient care.
  • Highly Specialist Services (tier 4): these include day and inpatient services, and highly specialist outpatient services for children and young people with the most serious problems.  It can also include crisis or home treatment services which provide an alternative to hospital admission.  These services are usually commissioned on a regional or national basis.
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