How urgent is urgent? Analysing urgent out-patient referrals to an adult psychiatric service

INTRODUCTION: It was noticed that over sonic years the number of referrals to the outpatient clinic (from various sources) which were marked 'urgent' had increased. We aimed to examine who makes these urgent referrals and the clinical factors associated with 'urgent' status. METHODS: A sample of 201 referrals over a 26-month period was examined. Det ails of the referral requests were collected using a specially designed for m. After each 'urgent' assessment, the referral was scored for appropriaten ess. This gave an indication of the agreement between referrer and clinic d octor as to what should constitute an 'urgent' referral. RESULTS: The majority of urgent referrals were from community psychiatric n ul-scs, who, together with psychiatric social workers, make the most approp riate referrals. The more appropriate referrals clearly specified the clini cal factors associated with urgent need for uEview. Patients regarded as su icidal were not associated with significantly higher appropriateness scores . CONCLUSION: Referrers should try and make 'urgent' outpatient requests as s pecific as possible: more clinical detail gives a clearer picture to the cl inic doctor. Telephone consultations with general practitioners may help to ascertain a cleaver picture of urgent requests if detail is lacking. Healt h professionals may all benefit ft om education in suicidal risk assessment .