Youth in Mind

Get support for someone else

  • Before you complete the form please make sure you read the information about the different Youth in Mind services available.
  • Check which service the child or young person is eligible for here
  • Please complete the top three fields with your details and the rest of the form with the young person’s information.
  • If you need any help completing the form then please contact [email protected]
Select the provider on the dropdown menu which is your first choice of service for the person you are referring.
If you do not have the express consent of the child or young person, please obtain consent from them before making a referral.
Please include information about the problem they are experiencing, any support they have from family/friends/professionals, how long they have felt like this, if they are aware of or have been using any coping strategies to support these feelings.

What to expect next

Someone will be in touch in the next 5 working days to confirm receiving your referral and explain what happens next.

Full details on how we use your data and keep it safe can be found in our Privacy Policy.



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