Referrals of Patients With Mental Health Problems From Primary Care to Mental Health Services in Spain

Abstract

Background. It is estimated that 25% of people may experience one or more mental disorders in their lifetime. In Western countries, individuals with mild mental disorders are treated in Primary Care (PC) while those with more severe mental disorders are treated in Mental Health Services (MHS). The objective of this study was to examine referrals from PC to MHS, with a focus on identifying factors that contribute to patients missing their appointments with MHS and identifying characteristics associated with patients who are discharged after their initial mental health consultation. Methods. A descriptive, cross-sectional and observational study was carried out. The study analyzed all referrals to the Northern Community Mental Health Unit of Málaga from 1 July to 31 December 2018. Data were collected on factors that could impact patients' failure to attend their MHS appointment and being discharged after their first mental health consultation. The study used descriptive, bivariate, and multivariate analyses. Results. During the study period, a total of 1,521 referrals were made to MHS. Factors associated with a higher risk of not attending the MHS appointment included longer delays, younger age, female gender, and previous treatment at MHS. Patients who were more likely to be discharged after their first consultation were older, referred from PC, initially attended in PC center rather than mental health center, and did not have diagnoses of schizophrenia-related disorders, personality disorders, mood disorders, or deferred diagnosis. Conclusions. It is important to develop strategies to reduce missed appointments, as this can have negative impacts on patient outcomes and increase the burden on mental health services. The examination of referrals and factors contributing to missed appointments highlights the need for a more integrated and coordinated approach to mental healthcare delivery. This may involve closer collaboration between primary care providers and mental health specialists, as well as increased investment in community-based MHS and resources.