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Psychiatric clinics in primary care. The effect on general practitioner referral patterns
G Strathdee1, R M Brown, R J Doig
1Memorial Hospital, London, England.
Social Psychiatry and Psychiatric Epidemiology
|March 1, 1990
Summary
Family doctors referred 176 patients to psychiatrists, but only half were for psychological symptoms. Unacknowledged factors like female sex influenced referrals, impacting primary and secondary care relationships.
Area of Science:
- Psychiatry
- Primary Care Medicine
- Health Services Research
Background:
- Referrals from primary care to psychiatry are crucial for patient mental health management.
- Understanding referral patterns is key to optimizing psychiatric service delivery.
- The stated reasons for referral may not always reflect the underlying factors influencing physician decisions.
Purpose of the Study:
- To investigate the characteristics of patients referred from family doctors to outpatient psychiatric clinics.
- To identify the stated and unacknowledged factors influencing the referral process.
- To discuss the implications for community psychiatric services and primary-secondary care collaboration.
Main Methods:
- A consecutive series of 176 referrals from family doctors to psychiatrists in primary care outpatient clinics were analyzed.
- Data collected included patient demographics, presenting complaints, and diagnoses.
- Statistical analysis was used to identify factors associated with referral.
Main Results:
- Only half of the referrals explicitly cited psychological symptoms as the reason for referral.
- Chronic illnesses and psychotic disorders were common among referred patients.
- Factors such as female sex, presenting with physical ill-health, and absence of personality disorder influenced referrals but were not acknowledged.
Conclusions:
- The stated reasons for psychiatric referrals may not fully capture patient needs or physician decision-making.
- Unacknowledged factors significantly influence the referral process, highlighting potential biases or communication gaps.
- Findings underscore the need for improved communication and understanding between primary and secondary care to enhance psychiatric service delivery.