Co-producing the Dynamic Support Pathway Threshold Tool

The CAMHS Article 12 Forum is a space for young people with an interest in mental health and neurodivergency to share their views. “CAMHS” stands for Child and Adolescent Mental Health Services.

The CAMHS Article 12 Forum provides a range of opportunities for its members to shape and improve support provided by CAMHS. Their workstreams have included:

  • Developing videos
  • Reviewing documents
  • Editing website content
  • Sitting on interview panels


In October 2022, neurodivergent members of Article 12 responded to a request to review the Dynamic Support Pathway Threshold Tool. This document is used to assess level of need among young people and determine the level of support provided to them.

The young people suggested changes to the document and a new version of the Threshold Tool was created to take into account the young people’s feedback. The new version is now a working document. It is pending approval by commissioners.

Compare the two versions of the Dynamic Support Pathway Threshold Tool

The changes include:

  • Addition of an acronym buster to explain what abbreviations mean
  • Inclusion of advice for professionals from the young people. The first one is, “Don’t shy away from putting people in higher categories because risk will escalate without support”
  • Clearer language – For example, the old document used the word “regularly” in the inpatient column. This has been changed to “fortnightly or even weekly”. Avoiding ambiguity is especially important for autistic young people.

How did we listen, act and respond?


The Dynamic Support Team within CAMHS have worked with the Article 12 Forum before and know how capable and helpful the young people in the forum are. Peter and Emma from the Dynamic Support Team got in touch with Oma, who facilitates the Article 12 forum, and proposed the Threshold Tool as a new project for the young people in Article 12 to work on.

Oma shared the proposal with the Article 12 members via their WhatsApp group and asked the young people if they would like to help structure and design the Threshold Tool. The young people accepted the invitation, so Oma arranged a meeting for the young people to meet with Peter and Emma. The meeting was the first face-to-face meeting for Article 12 since the Covid-19 lockdowns. It was held at Saffron House and was also hybrid, with Emma joining the meeting online.

During the meeting, the young people looked at the original document, asked questions, and challenged the language and decisions within the tool. There was a discussion between the young people and Peter and Emma. Peter and Emma answered as many of the questions that the young people asked as they could and took notes of all of the young people’s suggestions.

At the end of the meeting, Peter and Emma promised to get back in touch with the young people to update them on the outcome of their suggestions.


Peter and the team considered the suggestions and made changes to the threshold tool. They knew that the young people’s suggestions will help the threshold tool suit neurodivergent young people. The tool is to be used with young people and their parents, so it is really important that neurodivergent young people can understand it.

Peter and Emma have sent the new version to the commissioners (decision-makers) for approval. They also took it to the Parents Dialogue Group, which is a meeting where parents help to improve services.


Oma has shared the initial and current versions of the threshold tool with the young people via their Whatsapp group, along with a thank you from Peter and Emma. This allows the young people to see the changes that have been made in response to their views. It also gives the young people an opportunity to verify that their suggestions have been listened to. The young people were also updated when the document was approved for use in CAMHS and started being used.

Impact & Learning

The new version of the tool was approved by managers in CAMHS. The Dynamic Support Register now have a new Threshold Tool that was co-created with young people. This is being used by CAMHS practitioners to help match young people up with the right support for them.

The young people in Article 12 have been updated on the status of the project and thanked for their contributions.

Pete from CAMHS’ Dynamic support facilitation team said the below:

“I can confirm that the threshold tool that we discussed with Article 12 was sanctioned and is being used in practice. The young people’s experiences, feedback, and recommendations were very helpful and insightful. Understanding and interpreting the tool is a lot easier, and the changes have certainly helped clarify issues. Their input has enabled us to take young people’s views on board, and make the tool is effective as possible.”

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