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To explore whether (direct) referrals from GPs to two Community Mental Health Team (CMHT) clinical psychologists differed from those received from both ‘Psychiatric’ (eg. consultant psychiatrists) and ‘Other’ sources.
Method:
The two psychologists retrospectively examined and coded the case files of all clients who attended them during a 12-month period. The six measures used were diagnostic prevalence and groups, co-morbidity, chronicity, previous hospital admission and CMHT contact Separate cross-tabulations and chi squared tests were conducted for the various dependent variables to profile differences across the three referral sources.
Results:
There was no difference in prevalence of Axis I disorders, co-morbidity and chronicity of disorders between ‘GP’ and ‘Psychiatric’ referrals to the two CMHT psychologists. However, although low in number, there were more eating and psychotic disorders among the ‘Psychiatric’ referrals, and more of these referrals had previous hospital admission and CMHT contact.
Conclusions:
‘GP’ referrals were similar to ‘Psychiatric’ referrals on some measures but differed on others. Hence, as to whether an ‘open access’ model of (direct) referral to CMHT clinical psychologists lowers the clinical threshold for referrals depends on which measures are deemed most critical. Consistently applying a composite index of referral ‘severity’ could prevent the former.
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