Consider active suicidal intent, recent suicide attempt, escalating or high-risk self-harm, immediate risk to others, or immediate safeguarding concerns.

Consider acute psychosis or mania, severe mood disorder requiring crisis care, severe eating disorder, severe behavioural disturbance requiring intensive services, or primary substance misuse.

For child services consider significant global developmental delay, moderate–severe learning disability, limited verbal communication preventing assessment, or profound/complex autism requiring a specialist MDT.