Psychiatric cases: an ethnography of the referral process.
Investigation into the referral histories of a consecutive series of new patients attending two psychiatric out-patient clinics questioned the assumption that only the more severe and problematic cases are selected by general practitioners for specialist referral. In 40% of cases, clinical indications only became decisive in relation to emergent difficulties in managing the case, while 38% of patients or their relatives requested referral. The implications of these observations are considered in relation to alternative models of psychiatric intervention in the management of psychosocial disorders in primary care.
Morgan
D
D
Health Services Research Unit, University of Kent, Canterbury.
D000293:Adolescent; D000328:Adult; D000368:Aged; D004739:England; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009497:Neurotic Disorders / Q000175:diagnosis; D010554:Personality Disorders / Q000175:diagnosis; D010817:Physician-Patient Relations; D011618:Psychotic Disorders / Q000175:diagnosis; D012017:Referral and Consultation; D013001:Somatoform Disorders / Q000175:diagnosis