Samaritans Reconnect

Information for Referrer

REFERRAL CRITERIA

  • The Reconnect program uses community-based early intervention services to assist young people aged 12 to 18 years who are homeless, or at risk of homelessness, and their families. Reconnect assists young people to stabilise their living situation and strengthen family relationships, improve their level of engagement with education, work, training and their local community through: case management, counselling, outreach, group work and family support/mediation.
  • Please consider referral criteria below before referring:
  • Young person is aged 12 to 18 years
  • Young person lives, works, or studies in the Newcastle, Lake Macquarie, Cessnock, Maitland and Port Stephens Local Government Areas.
  • Young person is at risk of homelessness as a result of personal and/or family circumstances, including disengaging from school.
  • We provide statistics to a data collection agency called Australian Department of Social Services to help the government understand more about youth homelessness. The data we send does not contain the young persons name and is combined with other clients’ information. It is used for statistical purposes only. The young person can nominate for their information not to be recorded. They will still receive the same level of service from Samaritans if they do not give consent.
  • Samaritans Reconnect Workers are Mandatory Reporters under Child Protection legislation. This means we must lodge a report to the Family and Community Services if we know or suspect that a child or young person is at risk of significant harm.
  • Please Note, Samaritans Reconnect is not a crisis service. If the young person is in immediate risk of harm and support is required please direct to relevant emergency department, or call the Mental Health Line on 1800 011 511 (24 hours), Link2Home 1800 152 152 (24 hours), or FaCS Helpline 132 111(24 hours).
  • Please return the referral form by fax or email. If you are unsure whether the referral is suitable, or would like to discuss your referral further, please call the contact number above and ask to speak with a Reconnect worker. You will be informed whether this referral has been accepted following our intake procedures.

DATE:

REFERRAL SOURCE:

Contact name: Position/Relationship:

Organisation (if applicable):

Phone: Mobile:Email:

DETAILS OF PRIMARY CLIENT:

Name:Gender:

Date of Birth: Age:

Address:

Phone Number:Email:

Current School/Education Facility Enrolled:

Aboriginal Torres Strait Is Cultural Identity:

Is a language other than English spoken at home?Yes No If yes, which language?

Has consent for this referral been obtained from Young Person: YesNo

Has consent for this referral been obtained from Parent/Carer/Guardian:YesNo

(Please Note: If the young person is under 16, the parent needs to be aware of the referral in order for us to make contact with the young person)

SIGNIFCANT FAMILY MEMBERS/OTHER PERSONS:

Name / Relationship / DOB / Address (If Different) / Contact Number

OTHER SERVICES WORKING WITH YOUNG PERSON:(e.g. FaCS, CAMHS, Headspace).

Name / Organisation / Contact Number/Email

Do we have young person’s permission to contact these services?Yes No

If Yes, please attach any relevant information and assessments, from G.P’s, CAMHS, Mental Health Clinicians, School Counsellors etc.

REASON FOR REFERRAL:– e.g. What is current cause of risk to young person becoming homeless, or what is causing them to be homeless. What support does the young person want and need? What are the young persons goals?:

CURRENT LIVING ARRANGEMENTS FOR YOUNG PERSON:(Please note that Reconnect is not an accommodation service)

CURRENT MENTAL HEALTH:(Please note that Reconnect is not a specialised mental health service)

CURRENT ENGAGEMENT WITH EDUCATION:

OTHER CHALLENGES/ISSUES PRESENTING FOR YOUNG PERSON(e.g, domestic/family violence, alcohol/other drug misuse, risk taking behaviour, self harm):

RIGHT NOW, WHAT ARE THE YOUNG PERSON’S PRIMARY…

Strengths:Challenges:

11

22

33

FORM COMPLETED BY:

Name: Signature:Date:

Thank you for making a referral to Samaritans Reconnect.

Please return the Referral (contacts above) preferably by email (or by fax).

We will generally be in touch in 24 hours, to introduce ourselves

and make future plans to meet with the young person in person.