Citation

Douglas L, Feeney L. Ir. J. Psychol. Med. 2016; 33(2): 105-109.

Copyright

(Copyright © 2016, Irish Institute of Psychological Medicine)

DOI

10.1017/ipm.2015.28

PMID

unavailable

Abstract

OBJECTIVEs. In recent decades mental health services have become increasingly community based and multidisciplinary. However, it is unclear if referrals have changed over this period. The aim of this study was to compare referrals to a community mental health service over a 30-year period.

METHOD. New referrals to a community mental health service were randomly sampled from 4 time points over a 30-year period, 1983, 1993, 2003 and 2013, using a mental health information system. Original referral letters were retrieved and anonymised. Referrals were compared with regard to referral sources, demographics, reason for referral, psychotherapy requests, urgency, risk concerns and subsequent hospital admission.

RESULTS. There was a 20-fold increase in the number of new referrals between 1983 and 2013. Over the 30 years there was a significant decrease in the proportion of referrals expressing concern about psychosis, but an increase in the proportion that were deemed urgent and which were concerned with suicidal risk. Referrals in 2013 were longer and more likely to contain requests for psychotherapy.

CONCLUSIONS. The work of community mental health teams is increasingly concerned with emotional crises. Although services are now more multidisciplinary, they have not been adequately resourced to meet these changing demands. © College of Psychiatrists of Ireland 2015.

Language: en

Keywords

human; Suicide; female; male; Psychiatry; Primary care; bipolar disorder; psychotherapy; suicidal ideation; depression; anxiety; psychosis; suicidal behavior; addiction; Psychotherapy; posttraumatic stress disorder; Ireland; primary medical care; eating disorder; controlled study; personality disorder; community care; hospital admission; automutilation; psychiatric department; mental health service; patient referral; psychotropic agent; psychologist; mania; social worker; patient counseling; attention deficit disorder; Counselling; obsessive compulsive disorder; occupational therapist; medical information system; Article; electronic medical record; Referrals; Community mental health