[Is it possible to improve psychiatric care through the referral process?].

OBJECTIVE

To evaluate the quality of referral from Primary Care to Mental Health and its relationship to the illness referred.

DESIGN

A descriptive retrospective study over 4 years on the quality of the process.

SETTING

Mental Health Centre II in the Autonomous Community of Murcia.

PATIENTS

209 patients referred by three Primary Care teams.

MEASUREMENTS AND MAIN RESULTS

91.4% of patients (C.I. 95%: 100%, 81.1%) were accepted with a referral report. 97.9% (C.I. 95%: 100%, 87.8%) presented a reason for psychiatric consultation. The report included the clinical history of the illness in 58.1% of cases (C.I. 95%: 70.3%, 45.9%); a diagnostic opinion was given in 79.6% (C.I. 95%: 91.1%, 68%); and 37.2% (C.I. 95%: 49.3%, 25%) were referred with a request for a specific consultation. 68.4% of the referrals (C.I. 95%: 81.8%, 54.9%) coincided with the Mental Health diagnosis. It was observed that among the most commonly referred pathologies: anxiety disorders (31.6%), affective (28.8%), personality (7.7%), psychotic (5.3%), and adaptive disorders (5.3%); diagnoses were commonly made for affective or anxiety disorders (p < 0.0001); the specific cause of referral of anxiety disorders was recorded (p < 0.01); and in cases of psychotic and personality disorders, the diagnoses did not coincide (p < 0.001).

CONCLUSIONS

Referral to Mental Health can be improved, fundamentally by sending a report which includes the clinical history and the reason for referral. It is common to express a diagnostic opinion on affective and anxiety disorders, to note a specific reason for referral in the case of anxiety disorders and not to specify personality and psychotic disorders.