How should referrals to consultation-liaison psychiatry be made? A multisite study of consultation-liaison psychiatry clinicians and medical referrers.

ObjectiveTo investigate views of consultation-liaison psychiatry (CLP) clinicians and medical referrers regarding optimal referral processes, referral form content, responses to unsatisfactory referrals, and referral appropriateness for inpatient CLP services in Australian hospitals.MethodA cross-sectional mixed-methods survey was distributed to CLP clinicians (n = 121) working across Australia and medical referrers (n = 73) recruited from two hospitals in Victoria and Tasmania. Ratings of referral processes and referral form content were compared between groups. Free-text responses on referral appropriateness were thematically analysed.ResultsBoth groups preferred digital referral systems supplemented by telephone calls, and referral forms combining free-text fields with checkboxes. Cross-group consensus emerged on the five most important referral form fields: patient identification, reason for referral, referrer details, Mental Health Act status, and urgency. CLP clinicians rated 14 of 25 referral form headings as significantly more important than medical referrers. Thematic analysis of referral appropriateness yielded five interpretive themes. A dominant view framed referral appropriateness as a quality threshold, while a minority argued that any genuine clinical uncertainty warrants CLP review.ConclusionThese findings provide an empirical foundation for optimal referral systems in CLP. Referral system design should combine hybrid electronic forms with targeted education, low-threshold discussion pathways and co-design with referrers.