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Covid 19 Information

Please visit www.ghc.nhs.uk/coronavirus/
You can now request support to see the Mental Health Support Teams in your school. Please complete this form and hit submit. Your completed form will be looked at by the team who will then contact you via email or telephone within one working week.

YMM Request for Support

  • All parts of the form will be treated in complete confidentiality unless there is a concern that you or someone you know is at risk of harm. In order for us to get in touch, we’ll need you to provide a contact telephone number (either a landline or a mobile) and your school email address on the form. This information will only be used to contact you and will not be shared. * REQUIRED
  • Although we will not share information we will need to tell a teacher or someone at the School that you have an appointment with us in order for you to be released from lessons. The reason for this appointment will be kept confidential. * REQUIRED
  • The data you enter into the form will be in compliance with our GDPR policy. If you’d like to understand how we look after the information you give us in a confidential way, please visit: www.ghc.nhs.uk
  • Are happy for us to contact you using the information you give us on this form * REQUIRED
  • The Mental Health Support Teams ARE NOT A CRISIS SERVICE. If you are unsafe or if you feel unable to keep yourself safe, please do not delay getting the help you need - www.ghc.nhs.uk/crisis
  • Please confirm you understand this is NOT a crisis service. The team monitor referrals Monday-Friday – 9am-5pm and we will aim to contact you about your referral within 4 working days of the referral being submitted. * REQUIRED
  • Can we contact you at this address?
  • Can we contact you on your home number?
  • Can we leave a voicemail? * REQUIRED
  • Would you prefer to be seen face to face in school or via an online virtual platform? * REQUIRED
  • Do you care for a disabled or ill parent or older sibling?
  • Are you in foster care?
  • Do you have any physical or learning disabilities/health problems that we need to be made aware of?
  • Have you spoken to someone in the YMM team using the YMM chat text service
  • For example what difficulties are you having? How long have they been affecting you? How do they affect you/your family, school work or friends?
  • For example big family changes, illnesses or the death of a loved one?
  • Are you worried about your own safety or the safety of somebody else?
  • Have you ever had thoughts of wanting to hurt yourself?
  • Have you ever had thoughts of not wanting to be alive anymore?
  • Have you ever acted on these thoughts?
  • How long have you been having these thoughts?
  • Where on the happiness scale do you currently sit?
  • Do you give us permission to contact any of the agencies supporting you?
  • To accept your request for counselling we prefer to have the contact details of your parent/carer. We will not contact them unless you give us permission to do so (unless we are extremely concerned about your safety or the safety of somebody else).
  • Do we have your permission to contact the parent/carer if necessary?