Psychiatric tertiary referral and clinical decision making

Australian Defence Force Centre for Mental Health Second Opinion Clinic - first ten years of operation

OBJECTIVES

The aim is to report the operation of the Australian Defence Force Centre for Mental Health (ADFCMH) Second Opinion Clinic (SOC) after its first 10 years of operation.

METHOD

Demographic data and clinical data were recorded and analysed for all Australian Defence Force (ADF) personnel (n=209) seen at the clinic from 2011 to 2021.

RESULTS

Assessment at the clinic led to a change in diagnosis from that given at the time of referral in 40.7% (n=85) of members seen. Of the total members assessed at the SOC, 55.9% (n=117) had been on an at least one operational deployment. Mood disorders were the most common mental disorders seen among personnel at the SOC.

CONCLUSIONS

The ADFCMH SOC is a valuable clinical resource supporting ADF health services nationally and provides an example of an effective mental health tertiary referral service.

Patterns of Referral to Clinical Psychology Services in the Ministry of Health Malaysia

Background

This descriptive study identifies the demographic characteristics and patterns of referral to clinical psychology services, which include types of diagnosis, types of referral and source of referrals in child, adolescent, adult and geriatric cases in Malaysia.

Methods

We utilised 2,179 referrals between January and December 2015 from six general hospitals and three mental health institutions that provide clinical psychology services.

Results

The percentage of male referrals (60.3%) is higher than that of female referrals (39.7%). Adult cases had the highest percentage of referrals (48.2%). Children (48.8%) and adolescent (28.1%) cases were mainly referred for psychological assessment. Meanwhile, adult cases (74.8%) were mainly referred for psychological intervention. Neurodevelopmental disorders was the diagnosis with the highest percentage of referrals recorded (41.4%), followed by depressive disorders (13.3%) and anxiety disorders (12.7%), and the combination of other disorders. Psychiatrists provided the highest number of referrals (82.2%), which is unsurprising as both fields are closely related.

Conclusion

Clinical psychology services within the Ministry of Health (MOH) Malaysia play an important role in mental health care.