Failure to improve appropriateness of referrals to adult community mental health services--lessons from a multi-site cluster randomized controlled trial.

Background: Non-clinical factors impact on decisions about whether to refer a patient from primary care to specialist mental health services. The aim of this study was to investigate whether introducing a standardized assessment of severity improves agreement on referrals.

Methods: Multi-site mixed-method cluster randomized controlled trial, investigating GP referrals from 73 practices (408 839 patients) to 11 community mental health teams (CMHTs).

Loss of doctor-to-doctor communication: lessons from the reconfiguration of mental health services in England.

Objective: To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties.

Methods: A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and Manchester, UK. For the qualitative study, interviews were carried out with general practitioners (GPs), psychiatrists and managers or clinical leads of the CMHTs.

A qualitative study of referral to community mental health teams in the UK: exploring the rhetoric and the reality.

Background: Generic community mental health teams (CMHTs) currently deliver specialist mental health care in England. Policy dictates that CMHTs focus on those patients with greatest need but it has proved difficult to establish consistent referral criteria. The aim of this study was to explore the referral process from the perspectives of both the referrers and the CMHTs.