Details

Autor(en) / Beteiligte

• Pulier, Myron L
• Ciccone, Donald S
• Castellano, Cherie
• Marcus, Karen
• Schleifer, Steven J

Titel

Medical versus nonmedical mental health referral: clinical decision-making by telephone access center staff

Ist Teil von

• The journal of behavioral health services & research, 2003-10, Vol.30 (4), p.444-451

Ort / Verlag

United States: Springer Nature B.V

Erscheinungsjahr

2003

Quelle

Psychology & Behavioral Sciences Collection (EBSCOhost)

Beschreibungen/Notizen

• A database review investigated decisions of clinicians staffing a university-based telephone access center in referring new adult patients to nonpsychiatrists versus psychiatrists for initial ambulatory behavioral health care appointments. Systematically collected demographic and clinical data in a computer log of calls to highly trained care managers at the access center had limited predictive value with respect to their referral decisions. Furthermore, while 28% of the 610 study patients were initially referred to psychiatrists, billing data revealed that in-person therapists soon cross-referred at least 20% more to a psychiatrist. Care managers sent 56% of callers already taking psychotropic medications to nonpsychiatrists, 51% of whom were then cross-referred to psychiatrists. Predictive algorithms showed no potential to enhance efficiency of decisions about referral to a psychiatrist versus a nonpsychiatrist. Efforts to enhance such efficiency may not be cost-effective. It may be more fiscally efficient to assign less-experienced personnel as telephone care managers.