The consequences of an open referral system to a community mental health service

Marriott, Sarah; Malone, Stephen D.; Onyett, Steve; Tyrer, Peter

doi:10.1111/j.1600-0447.1993.tb03420.x

Cited by 36 publications

(6 citation statements)

References 16 publications

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“…A previous randomized controlled study found that patients referred to the EIS showed greater improvement in symptoms and were more satisfied with the service than those in a hospitalbased service (12), and that this was achieved at 43% of the cost of the traditional service (13). A further study concluded that an open referral system such as the EIS was likely to be more sensitive to need and to have some advantage over closed referral arrangements in inner-city areas (14). This study showed that the most severely ill patients referred to the service were not referred by general practitioners or psychiatrists but by other agencies.…”

Section: Discussionmentioning

confidence: 81%

General practitioners’ views of an open referral system to a community menial health service

Puri

Hall

Reefat

et al. 1996

Acta Psychiatr Scand

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The satisfaction of general practitioners with a community mental health service operating an open referral system was compared to that with two services both operating a closed referral system covering the same inner-city district. The open referral system allows any agency (including patients) to contact the service by letter or by telephone, and priority is given to patients with serious mental illness. General practitioners' satisfaction with all aspects of the open referral system was greater than that with either of the closed referral systems. In particular, speed of assessment of referrals was preferred in the open referral system.

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Section: Discussionmentioning

confidence: 81%

General practitioners’ views of an open referral system to a community menial health service

Puri

Hall

Reefat

et al. 1996

Acta Psychiatr Scand

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“…This is a matter of further investigation. An interesting study by Marriott et a1 (23), investigating the introduction of an open referral system, showed that GPs and other doctors made as many inappropriate referrals as other referral sources, including patient self-referrals, and that patients with a severe illness to a significantly greater extent were referred from other sources than the GP. This shows that setting priorities of the psychiatric services and directing resources towards patients with severe illness is more complicated and affected by a number of other variables than the mode of referral.…”

Section: Discussionmentioning

confidence: 99%

The Nordic comparative study on sectorized psychiatry I. Treated point prevalence and characteristics of the psychiatric services

Hansson

Øiesvold

Göstas

et al. 1995

Acta Psychiatr Scand

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Comparative studies relating characteristics of psychiatric services to rates of treated prevalence are scarce. As part of a Nordic comparative study on sectorized psychiatry, a point-prevalence study was performed in 5 sectorized psychiatric services with comprehensive service facilities for a defined population under responsibility. The rates of treated prevalence on a census day were related to a number of characteristics of the respective services and to accessibility of care. The results showed a great variation in one-day point prevalence in the 5 services, with almost fourfold differences. There were also marked differences in the diagnostic distribution of the cohorts. A positive correlation was found between number of beds and point prevalence, measured both as total point prevalence and impatient prevalence. The rates of beds and psychiatrists were most strongly related to the prevalence of patients with organic disorders and functional psychoses. A closed referral system was associated with a lower level of treated prevalence.

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“…Providing a single point of access improves service accessibility (Onyett et al 1994) and ensures referrals are jointly considered for both health and social care provision (Newton et al 1996). Open referral systems have been found to be effective in increasing accessibility of services to the most severely ill people (Marriott et al 1993), although rigorous application of eligibility criteria becomes particularly important when referrals are accepted from a wide range of sources (Onyett et al 1994). This may particularly challenge professionals used to accepting and offering interventions to all new referrals (Newton et al 1996).…”

Section: Introductionmentioning

confidence: 99%

Joint working in community mental health: prospects and challenges

Hannigan

1999

Health & Social Care in the Community

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This paper reviews the opportunities for, and the challenges facing, joint working in the provision of community mental health care. At a strategic level the organization of contemporary mental health services is marked by fragmentation, competing priorities, arbitrary divisions of responsibility, inconsistent policy, unpooled resources and unshared boundaries. At the level of localities and teams, these barriers to effective and efficient joint working reverberate within multi-disciplinary and multi-agency community mental health teams (CMHTs). To meet this challenge, CMHT operational policies need to include multiagency agreement on: professional roles and responsibilities; target client groups; eligibility criteria for access to services; client pathways to and from care; unified systems of case management; documentation and use of information technology; and management and accountability arrangements. At the level of practitioners, community mental health care is provided by professional groups who may have limited mutual understanding of differing values, education, roles and responsibilities. The prospect of overcoming these barriers in multidisciplinary CMHTs is afforded by increased opportunities for interprofessional 'seepage' and a sharing of complementary perspectives, and for joint education and training. This review suggests that policy-driven solutions to the challenges facing integrated community mental health care may be needed and concludes with an overview of the prospects for change contained in the previous UK government's Green Paper, 'Developing Partnerships in Mental Health'.

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The consequences of an open referral system to a community mental health service

Cited by 36 publications

References 16 publications

General practitioners’ views of an open referral system to a community menial health service

General practitioners’ views of an open referral system to a community menial health service

The Nordic comparative study on sectorized psychiatry I. Treated point prevalence and characteristics of the psychiatric services

Joint working in community mental health: prospects and challenges

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