{"id":696,"date":"2017-08-07T11:00:49","date_gmt":"2017-08-07T11:00:49","guid":{"rendered":"https:\/\/www.nhslref.scot.nhs.uk\/?p=696"},"modified":"2017-08-07T11:00:49","modified_gmt":"2017-08-07T11:00:49","slug":"mental-health-psychology-referral","status":"publish","type":"post","link":"https:\/\/www.nhslref.scot.nhs.uk\/?p=696","title":{"rendered":"Mental Health (Psychology) Referral"},"content":{"rendered":"<h3>Access to service by General Practitioner<\/h3>\n<h3>Mental Health One Door Access (Older People)<\/h3>\n<p>People over the age of 65 with a psychological\/emotional\/severe or enduring mental health problem, including dementia.<\/p>\n<h3>Cognitive Impairment<\/h3>\n<ul>\n<li>Evidence of memory impairment. Please:\n<ul>\n<li>consider and exclude delirium, particularly if history is less than 6 months<\/li>\n<li>include recent cognitive screening and routine physical investigations*<\/li>\n<\/ul>\n<\/li>\n<li>Stress and distress which may cause harm to self or others, or affect quality of life (previously known as challenging behaviour)<\/li>\n<li>Family education and support<\/li>\n<li>Management of functional impairment (including OT assessment)<\/li>\n<li>Medication review<\/li>\n<\/ul>\n<h3>Severe or Enduring Mental Health Problems<\/h3>\n<ul>\n<li>Psychosis including schizophrenia<\/li>\n<li>Bipolar affective disorder<\/li>\n<li>Obsessive compulsive disorder<\/li>\n<li>Enduring and severe anxiety and\/or depression<\/li>\n<li>Difficulties related to pervasive personality issues<\/li>\n<\/ul>\n<h3>Other Mental Health Difficulties<\/h3>\n<ul>\n<li>Moderate to severe anxiety disorders e.g. GAD, panic, agoraphobia, health anxiety<\/li>\n<li>Moderate to severe depression<\/li>\n<li>Trauma reactions &#8211; including PTSD, sexual\/emotional\/physical abuse in childhood or adult life<\/li>\n<li>Adjustment difficulties &#8211; including to physical health problems, prolonged or atypical bereavement reactions<\/li>\n<li>Single psychotic episode<\/li>\n<li>Thoughts\/ideas of self harm\/suicide in conjunction with any of the above criteria<\/li>\n<\/ul>\n<p>High priority\/urgent referrals should be followed up by a phone call to the relevant locality team to discuss degree of urgency, timescale for appointment etc.<\/p>\n<h3>* Routine Physical Investigations<\/h3>\n<p>A standard physical examination guided by symptoms +\/- : BP, MSSU if indicated by history, CXRay if indicated by history, ECG if indicated by history etc.<br \/>\nNeuro-imaging is NOT expected\/required to be ordered prior to referral.<br \/>\nNICE\/RCPsych guidance on blood tests recommends full blood count, ESR or C-reactive protein (CRP), vitamin B12, folate, thyroid function, urea and electrolyte, calcium, liver function and glucose tests, with blood tests for syphilis, lipids and HIV listed as &#8216;optional&#8217;. (Royal College of Psychiatrists, 2005b).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Access to service by General Practitioner Mental Health One Door Access (Older People) People over the age of 65 with a psychological\/emotional\/severe or enduring mental health problem, including dementia. Cognitive Impairment Evidence of memory impairment. Please: consider and exclude delirium, particularly if history is less than 6 months include recent cognitive screening and routine physical [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[99,100,140],"class_list":["post-696","post","type-post","status-publish","format-standard","hentry","category-all-referrals","category-gp-referrals","tag-mental","tag-mental-health","tag-psychology"],"_links":{"self":[{"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/posts\/696","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=696"}],"version-history":[{"count":1,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/posts\/696\/revisions"}],"predecessor-version":[{"id":697,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=\/wp\/v2\/posts\/696\/revisions\/697"}],"wp:attachment":[{"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=696"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=696"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nhslref.scot.nhs.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=696"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}