REFERRAL SYSTEM FOR THE MENTALLY ILL

Referral is the sending of a patient to a higher or the same level of care/management.

When Referral Is Done:

• When a service provider is not able to manage the patient, they may decide to refer the patient for highly specialized care.

• In relation to mental health, diagnosis of schizophrenia (S/Z) is a serious matter and is not easy to make.
  → It is therefore recommended that referrals be made to a psychiatrist in case a nurse suspects a patient to be having this condition.

• Another reason for referral:
  → If the patient has been on treatment (Rx) for 1–2 weeks without symptoms improving.

• Referrals may also be made in cases of drug reactions where the nurse feels unable to manage.

NB: Sometimes patients may be referred downwards, but the best term for this is transfer, such as when:

• The patient has already been stabilized on treatment

• They now require follow-ups from a nearby health facility

→ This helps save the patient transport expenses.

ROLE OF A NURSE FROM THE LOWER HEALTH FACILITY HANDLING THE REFERRED/TRANSFERRED PATIENT

• Regular review of the patient

• Checking for reoccurrence of symptoms

• Ensuring that the patient is taking the medications as prescribed

• Makes a social life and asks if the patient is getting side effects from the drug

• Provides a prescription for the patient, usually following that of the transferring/referring doctor

• It is not wise to adjust the dosage of the medication unless:

  • The referring doctor has been consulted, or

  • The doctor wrote instructions that after a certain period the dose should be adjusted to a specific amount

SUMMARY OF THE REFERRAL SYSTEM