Referrals for assessment of neuropsychiatric disabilities within CAMHS in Västra Götaland

Purpose of the study

This study aims to investigate aspects of referral quality regarding neuropsychiatric problems (NP) in referrals sent to the region-wide referral portal En väg in (EVI) within adolescent mental health care services (CAMHS) in Region Västra Götaland. Quality aspects examined include the content, accuracy, and relevance of the data presented in the referrals. We will assess if the referrals contain sufficient information to support an effective investigation process.

Design of the study

A key part of our study will be to compare referrals from different referrers and healthcare providers. We will analyze the critical referral content factors for a successful investigation. This may include specific clinical indicators, details in descriptions, and clarity. The study will also focus on identifying gaps or errors in referral content. This may include missed symptoms, inaccurate medical history, or lack of information about the patient's past health. We will conduct a careful analysis of variations between different patient groups. By identifying which providers generally send more informative and well-formulated referrals, we may be able to conclude training needs or improvement measures. The results will be useful for targeting interventions to specific areas and making them more effective for patients with the greatest needs.

The study aims to analyze the data from 4000 referrals and half of the patients are admitted for an NP investigation. An independent panel of multidisciplinary experts, separate from EVI, will evaluate incoming referrals. We will use a scoring system to assess various aspects derived from the referrals such as motor skills, executive functions, perception, memory, language, and family situation. The panel will determine whether the referral is eligible for acceptance for a NP investigation and if additional information is necessary. In the second stage, approximately 100 referrals will be thoroughly reviewed.

Research questions

Research questions will address if there are differences in

1. the quality of referrals between categories of referrers (student health, primary care, and self-referral)?

2. the quality of referrals depending on the professional category (doctor, psychologist, nurse, counselor, special educator)?

3. in the number, content and quality of referrals depending on socio-demographic factors (e.g. gender, age, family situation, ethnic background, geography)?

and investigate

4. what information is most crucial in the referral?

Researchers

Ole Hultmann, University of Gothenburg and CAMHS Göteborg

Rajna Knez, Skaraborg Hospital

Sara Lundqvist, CAMHS Gothenburg

Michail Theodosiou, Regional Investigation Clinic, Region Västra Götaland