Perceptions of Appropriateness of Psychiatric Referrals by Healthcare Professionals in a General Hospital
American Journal of Psychiatry and Neuroscience
Volume 7, Issue 1, March 2019, Pages: 19-23
Received: Apr. 3, 2019;
Accepted: Jun. 2, 2019;
Published: Jun. 12, 2019
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Leslie Lim, Department of Psychiatry, Singapore General Hospital, Republic of Singapore
Jeremy Heng, Department of Psychiatry, Singapore General Hospital, Republic of Singapore
Yiong Huak Chan, Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
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Objective: We assessed hospital staff recognition of certain psychiatric symptoms and whether they considered it appropriate to refer patients with these symptoms to the consultation-liaison psychiatric service. Methods: An online questionnaire was sent to all healthcare professionals working in the hospital. We presented several vignettes describing the typical symptoms and behaviors of a case of schizophrenia, major depression, generalized anxiety disorder, delirium and dementia. Staff were asked whether they considered it appropriate for a patient with these symptoms to be referred to the psychiatrist. Results: Doctors were significantly more likely to endorse psychiatric referrals for depression (p = 0.023) and schizophrenia (p < 0.001). Although there appeared to be non- significant responses for the remaining conditions, within group analyses suggested that the more experienced staff and foreign born and foreign trained staff were more likely to endorse psychiatric referrals for anxiety, dementia and delirium. Conclusions: Knowledge deficits exist among hospital staff in our hospital. This highlights the possibility of non- detection and non-referral of certain psychiatric comorbidities among patients receiving medical care.
Psychiatric Referrals, General Hospital, Mental Health Literacy
To cite this article
Yiong Huak Chan,
Perceptions of Appropriateness of Psychiatric Referrals by Healthcare Professionals in a General Hospital, American Journal of Psychiatry and Neuroscience.
Vol. 7, No. 1,
2019, pp. 19-23.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
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Lipowski ZJ. Review of consultation psychiatry and psychosomatic medicine II: Clinical aspects. Psychosomatic Medicine 1967; 29: 201-224.
Dhossche DM, Lorant Z. Psychiatric consultations in a southern university hospital. South Med J. 2002; 95 (4): 446–9.
Lappalainen-Lehto R, Seppa K, Nordback I. Cutting down substance abuse– present state and visions among surgeons and nurses. Addict Behav. 2005; 30 (5): 1013–8.
Chen KY, Evans R and Sarah Larkins S. BMC Psychiatry 2016 16: 390 DOI 10.1186/s12888-016-1100-6.
Su JA, Tsai CS, Hung TH, Chou SY. Change in accuracy of recognizing psychiatric disorders by non-psychiatric physicians: five-year data from a psychiatric consultation-liaison service. Psychiatry Clin Neurosci. 2011; 65 (7): 618–23.
Mezey AG, Kellett JM. Reasons against referral to the psychiatrist. Postgrad Med J. 1971; 47 (548): 315–9.
Thom R, Silbersweig DA, Boland RJ. Major depressive disorder in medical illness: A review of assessment, prevalence, and treatment options. Psychosom Med. 2019 Feb 1. doi: 10.1097/PSY.0000000000000678. [Epub ahead of print].
Jorm, AF, Korten A E, Jacomb P A, Christensen, H., Rodgers, B. et al (1997a). Mental health literacy: a survey of the public’s ability to recognise mental disorders and their beliefs about the eﬀectiveness of treatment. Med J Aust. 1997a; 166: 182-186.
Yeo SG, Parker G, Mahendran R, Jorm AF, Yap HL, Lee C, et al. Mental health literacy survey of psychiatrically and generally trained nurses employed in a Singapore psychiatric hospital. International Journal of Nursing Practice 2001; 7: 414–421.
Seow LSE, Chua BY, Xie H, Wang J, Ong HL, Abdin E, et al. Correct recognition and continuum belief of mental disorders in a nursing student population. BMC Psychiatry 2017; 17: 289 DOI 10.1186/s12888-017-1447-3.
Parker G, Mahendran R, Yeo SG, Loh MI, Jorm AF. Diagnosis and treatment of mental disorders: a survey of Singapore mental health professionals Soc Psychiatry Psychiatr Epidemiol. 1999; 34: 555-563.
Ng BY. Till the Break of Day: A History of Mental Health Services in Singapore, 1841-1993. Singapore: Singapore University Press, 2001.
Razali SM, Khan UA, Hasanah CI. Belief in supernatural causes of mental illness among Malay patients: impact on treatment. Acta Psychiatr Scand. 1996; 94: 229-33.
Lim L, Goh J, Chan YH, Poon SH. Mental Health Literacy and the Belief in the Supernatural. Open Journal of Psychiatry 2015; 5: 334-341.