Quality of psychiatric referrals to secondary-level care

  • W Struwig
  • PJ Pretorius


Objectives. This study examined the quality of referrals to
secondary-level outpatient psychiatric services rendered by the
Department of Psychiatry, University of the Free State. Referral
letters were evaluated according to specific quality criteria.
Aspects that would enable secondary-level doctors to make
informed decisions in terms of further management and need
for special investigations were specifically considered.
Design. A descriptive study design was used, and convenience
sampling included all referrals to the unit over a 6-month period
(June - November 2007). All referral letters were screened
according to a checklist designed for this study.
Setting. The study was undertaken at the Psychiatry Outpatient
Department of the Pelonomi Provincial Hospital in Bloemfontein,
which functions as a secondary-level referral centre for mental
health in the southern Free State.
Outcome measures. Descriptive statistics (percentages, means
and standard deviations) were used to summarise results.
Results. Two hundred and sixty-three referral letters were included in the study. Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special  investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system.
Conclusion. There was conclusive evidence that the quality
of referrals to the Psychiatry Department was generally inadequate. A need for more effective referral strategies was identified.

Journal Identifiers

eISSN: 2078-6786
print ISSN: 1608-9685