Referral of patients with mental disorders from Primary Care to Mental Health Units

Introduction. Most part of the patients suffering from mental disorders are treated by non-psychiatrist physicians, mainly by general practitioners (GPs). The aim of this study has been to analyse the factors influencing the referral of patients with mental illness to psychiatric services. Methods. Using data of referrals from two Primary Care Centres (population: 28.039) to a Mental Health Unit in one year period, we analysed clinical records, information provided with the referral and the opinion of GPs about mental illness. Resultados. Out of the 486 referrals, the 153 patients without previous consultations were included in the analysis. Men, and those with higher educational status were referred more frequently. A 34% of the referrals included information about psychopathological symptoms, and 70% included clinical diagnosis. Primary care physicians specialised in family medicine included more data regarding psychopathological symptoms, and included a specific request more often than GPs without specialised training. Diagnostic accuracy (61%) were lower for adjustment and personality disorders, and in those patients with an urgent referral. Patients with an urgent referral did not present different clinical features, nor different severity than those with an ordinary referral. Conclusions. Management of patients with mental disorders in PHC should be improved with guidelines about treatment and referral. Different levels of care should be coordinated.