title: Recommended content of referral letters from general practitioners to specialised mental health care: a qualitative multi-perspective study.
abstract: BACKGROUND
  In most Western countries, the referral letter forms the basis for establishing the priority of patients for specialised health care and for the coordination of care between the services. To be able to define the quality of referral letters, the potential impact of the quality on the organisation of care, and to improve the quality of the letters, we need a multidimensional definition of the ideal content. The study's aim was to explore what information is seen as most important and should be included in referral letters from primary care to specialised mental health care to facilitate prioritisation and planning of treatment and follow-up of the patients.
  
  
  METHODS
  Based on purposive sampling, four mixed discussion groups, which included general practitioners, mental health nurses from primary health care, psychiatrists and psychologists from specialised mental health care, managers and patient representatives, were formed; they were asked to identify the information they considered important in a mental health referral letter. In line with the Delphi technique, the importance of the themes was later individually rated by the participants. The study was conducted within The Western Norway Regional Health Authority.
  
  
  RESULTS
  The four groups identified 174 information themes. After excluding themes that were assessed as duplicates, replaceable or less important, 40 themes were suggested, organised in seven units. A set of check-off points of essential information is recommended as an introduction in the referral letter.
  
  
  CONCLUSIONS
  Compared with general guidelines and guidelines for somatic care, the results of this study suggest that the referral letter to specialised mental health care should have a larger emphasis on the overall treatment plan, on the specific role of specialised health care in the continuum of care, and on patient involvement. Further research should evaluate the validity of these findings for other patient groups in need of integrated care and investigate how the quality of referral letters affects patient-related and organisational outcomes.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  NCT01374035.
authors: Research Network on Integrated Health Care in Western Norway, Helse Fonna HF, Valen Hospital, N-5451, Haugesund, Valen, Norway. miriam.hartveit@helse-fonna.no
authors: Miriam
authors: M
authors: Hartveit
authors: Olav
authors: O
authors: Thorsen
authors: Eva
authors: E
authors: Biringer
authors: Kris
authors: K
authors: Vanhaecht
authors: Benedicte
authors: B
authors: Carlsen
authors: Aslak
authors: A
authors: Aslaksen
mesh_terms: D015709:Correspondence as Topic; D003697:Delphi Technique; D017144:Focus Groups; D058006:General Practice; D006801:Humans; D008605:Mental Health Services; D009664:Norway; D011320:Primary Health Care; D058996:Quality Improvement; D012017:Referral and Consultation
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