Dynamic Support Register (DSR) and Keyworker Service

The Dynamic Support Register (DSR) helps people who work with children and young people. It helps them work together to support those with a learning disability, autism, or both, who may be at risk of having a mental health crisis or needing to go to a mental health hospital.

When a child or young person is on the DSR, services can spot early signs that they may need extra help. This means they can get the right support before problems become a crisis.

Being on the DSR does not mean a child or young person will have to go to hospital. The main aim is to give support in the community and help prevent a hospital stay.

A child or young person will be considered for the DSR if they:

• have a learning disability, are autistic, or have both
• are at risk of needing admission to a mental health hospital

This could include children and young people who are experiencing:

• worsening mental health or emotional wellbeing
• increasing distress or behaviours that are causing concern
• risk of harming themselves or others
• difficulties that are putting their home, education or care placement at risk of breaking down
• repeated mental health crises or increasing involvement from different services
• a recent or current admission to a mental health hospital

Every referral is considered individually and professionals will look at each child's circumstances and support needs.

Children and young people on the DSR are regularly discussed by professionals from different services to make sure they are getting the right support.

These professionals may include people from:

• health services, including mental health and community teams
• education
• children's social care
• other services involved in supporting the child or young person

Together they will:

• review what is working well and where extra support may be needed
• share important information (with appropriate consent and information-sharing arrangements)
• agree a coordinated plan of support
• monitor progress and review support regularly

Sometimes these discussions take place through a Care, Education and Treatment Review (C(E)TR) or a Dynamic Support meeting. Families, carers and, wherever possible, the child or young person are an important part of these conversations.

Your views, experiences and wishes should always help shape decisions about support.

Some children and young people on the DSR may get support from a Keyworker.

A Keyworker gives extra help to children and young people who are most likely to need mental health hospital care, or who are already staying in hospital for their mental health.

Your Keyworker will be your main contact. They will help everyone involved work together so your child gets the right support at the right time.

The Keyworker Service supports a small number of children and young people who:

• are on the Dynamic Support Register (DSR) and
• have the highest risk, or a growing risk, of being admitted to a mental health hospital, or
• are staying in a mental health hospital and receiving inpatient care

We offer support based on each child's needs, level of risk and the amount of support they need.

A Keyworker can:

• be the main contact for your family
• help health, education and social care services work together
• make sure your child's and family's views are listened to
• support care and support planning and reviews
• help your family understand and use different services
• keep people informed and improve communication between professionals
• help reduce the risk of a crisis where possible
• support planning if your child needs to go into hospital and help plan their discharge when they leave

The Keyworker Service helps bring services together so families get joined-up support. It reduces the need for families to tell their story more than once and helps children and young people achieve the best possible outcomes.

Referrals to the DSR are made by professionals who know your child or young person.

This might include:

• your GP or paediatrician
• Child and Adolescent Mental Health Services (CAMHS)
• social workers
• school staff or SENCOs
• community learning disability or autism teams
• other health or care professionals

If you are worried about your child's mental health or wellbeing, speak to a professional who is already involved with your family. They can discuss whether a referral to the DSR may be appropriate.

Once a referral has been made:

• the referral is reviewed by the DSR panel
• the panel considers your child's current needs, risks and the support already in place
• a decision is made about whether your child should be added to the DSR
• if appropriate, the panel will also consider whether a Keyworker should be allocated
• a coordinated plan of support will be developed and reviewed regularly to make sure it continues to meet your child's needs.