Experiences with psychiatric referrals

The nature of referral attrition can be studied by looking at the period between the referring physician's decision to seek psychiatric help for his patient and the patient's contact with the psychiatrist. Examples of breakdowns in the process are given, in comparison with results of outcome studies of patient orientation for psychotherapy. Bridging interviews would be beneficial, because they would help the patient align his/her expectations with the realities of the psychiatric interview. The educational and remoralizing functions of the referring physician are exemplified. The importance of the power position of the family physician to influence the course of the referral process and even the early stages of psychiatric treatment are kept in the foreground. Furthermore, the cost effectiveness of mental health care delivery, an important issue today, would improve if the referral process were more effectual.