Youth Trust Self Referral

Please note - if you are referring on behalf of a young person over the age of 13, you will need to provide THEIR email details in order to complete this referral. If you do not have these details please call us on 01983 529569 to continue.


If the young person is UNDER 13 - we require the parent/carer to consent to the referral. The young person should be made aware of the referral and all those with parental responsibility must be in agreement.
If the young person is OVER 13 - if you are a parent/carer making this referral on behalf of a young person over the age of 13, please ensure you have their consent to make the referral. It is their consent we need, we do not require parental consent for young people over the age of 13.


If the young person is UNDER 13 please complete the following:


If you/the young person is OVER 13 please complete the following:

Hampshire and Isle of Wight CCG commission a number of organisations to support and treat children and young peoples mental health. To ensure that your referral reaches the right service to meet your needs, we may need to share your information with other organisations, which could be the Isle of Wight NHS Trust, Youth Trust or Barnardos.
It may be necessary to share information with other professionals if Youth Trust is deemed not appropriate upon review, this is so we can offer the best service. During the course of care, some details may be recorded digitally. For your protection, the use of this data is controlled in accordance with the Data Protection Act, 2018.
The Isle of Wight Youth Trust will always store your personal details securely. We will use them to communicate with you in the ways you have agreed and may also use your data for administrative and analysis purposes. Our full privacy notice can be found at
For full details on how we use personal data, please contact us: Youth Trust House, 114 Pyle Street, Newport, Isle of Wight PO30 1XA (01983) 529 569


If you are a parent/carer making the referral on behalf of a young person please provide your details:


If you do not have the email details, please call us instead on 01983 529569 to complete your referral.
If you/your child attends school you may want to speak to school about the services offered by the mental health support team (MHST) based within the school setting


* If 'Suicidal ideation (thoughts of)' has been selected and there is evidence of suicide attempts or intent, the young person should be referred directly to CAMHS (01983 523602). If a young person is at immediate risk call 999.
Once we have processed your referral, we will then send a digital & wellbeing counselling agreement by email (from DocuSign). After this has been completed, you will join the waiting list for an initial assessment where we will determine the most appropriate service for you, and we will contact you as soon as we have appointments available to book. Please bear with us and call 01983 529569 or email with any queries.


The Youth Trust is unable to provide crisis support. If you are in need of immediate support, please contact the numbers below:
If your life is at imminent risk or you need urgent medical attention – call 999 and ask for an ambulance.
If you feel that you are likely to harm yourself or are in danger of harming others, please call 111 or attend St. Mary’s Hospital A&E
There is always someone you can talk to if you need support:
If you are under 18 you can call Childline on 0800 1111 for free, they are available 24 hours a day, 365 days a year.
If you are aged over 18 you can call the Samaritans for free on 116 123, they are available 24 hours a day, 365 days a year.
Shout provides a free 24/7 text crisis support service, to start a conversation, just text the word ‘SHOUT’ to 85258. It is a confidential, anonymous service for anyone in the UK and details won’t appear on your phone bill.