Referral criteria from primary care - schizophrenia

Referral of first psychotic episode

• early referral
  • refer urgently all people first presenting with psychotic symptoms in primary care to a local community-based secondary mental health service (early intervention services, crisis resolution and home treatment team, or community mental health team). The appropriate team should be chosen based on the stage and severity of illness and the local context
    
    

Re-referral to secondary care

• consider re-referral to secondary care if there is:
  • poor treatment response
  • non-adherence to medication
  • intolerable side effects from medication
  • comorbid substance misuse
  • risk to the person or others
• consult the care plan and consider referral to the key clinician or care coordinator stated in the crisis plan if a person with established schizophrenia has a suspected relapse (for example, increased psychotic symptoms or increased use of alcohol or other substances)
• rereferral should take account of service user and carer requests, especially for review of the side effects of current treatment, and for psychological treatments or other interventions

Reference:

• 1. NICE (March 2009). Schizophrenia Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care