Closer working with primary care is associated with a sharp increase in referrals to community mental health services

Abstract

Objectives :To study the effect of establishing closer links with general practitioners on referrals to community mental health teams and to discuss implications of the findings for implementing standards 2 and 4 of the National Service Framework for Mental Health. Design : Cohort study. Setting : Plymouth inner city mental health services. Main outcome measures : Numbers of referrals to the community mental health teams, the emergency psychiatric service and acute psychiatric admissions in the 12 months before and after services were reconfigured to provide closer working arrangements with primary care. Results : There was an approximately three-fold increase in referrals to the community teams following reconfiguration, but no significant difference in the number of emergency referrals or the numbers admitted. Conclusions : Linking community psychiatric nurses with primary care increased demand for secondary mental health services. Clear referral guidelines and shared care protocols should be in place before service change is implemented. implications in the light of increased workload for staff carrying out more assessments. There are also resource