GPs and psychiatrists: best practice guidelines for referral and communication

This information is for Australian psychiatrists and GPs, to support best practice clinical collaboration. Good communication between GPs, psychiatrists and other allied health professionals is crucial to providing high quality treatment to patients.

About referral from GPs to psychiatrists

Patients can be referred to psychiatrists by GPs for either:

  • ongoing care – which might involve transfer of care or a shared care arrangement
  • an 'opinion and report' (MBS item 291) – where the GP continues to act as the primary health-care provider.

.More about item 291

.Flowchart illustrating the pathway for GP referrals to private psychiatrists

Guidelines for psychiatrists

Communicate regularly with the referring GP. As part of good clinical care, communicate in writing or orally with the GP following psychiatric assessments. If you are providing ongoing management, maintain regular communication with the GP.

For an 'opinion and report' (MBS item 291), you must provide a report to the GP within 2 weeks of the consultation.

Guidelines for GPs

To refer a patient to a psychiatrist, a letter of referral is required. The letter of referral should contain (where possible):

  • the reason for the referral
  • the main issues (a summary of the problems, the perceived contributors and any safety concerns)
  • medical history and the relevant medical and mental health treatment that has been provided
  • whether the referral is for an opinion and report or ongoing management
  • whether a psychologist has recommended the GP make the referral (include their specific concerns and contact details).

For assistance finding a suitable psychiatrist, the RANZCP's Find a Psychiatrist directory may be helpful.

If you are concerned about the safety of a patient you have referred to a psychiatrist, you should speak directly to the psychiatrist (over the phone or in person) to tell them about your concerns. This will allow them to take steps to ensure patient safety. Letters are not recommended as a way to convey urgent information.

Mental Health Treatment Plans are not required for psychiatrists, only psychologists. For psychologists, a Mental Health Treatment plan is needed to access Medicare rebates.

If a patient has not significantly improved 6 months after referral to a psychologist, it may be appropriate to refer the patient to a psychiatrist for a second opinion. Inform both parties of the referral.

If you wish to refer an active patient of a psychiatrist to a psychologist, discuss the arrangement with the psychiatrist first.

Simultaneous referrals from a GP to both a psychiatrist (for both psychotherapy and medication) and psychologist (for psychotherapy) can create confusion about treatment. Consider the need for this carefully on a case-by-case basis.

When referring a patient to a psychiatrist, it is important that you discuss the reason for the referral with the patient. This is to ensure that the patient and the psychiatrist have the same expectations from the appointment, including rebates from Medicare.

Development of these guidelines

The information on this page was drawn from the professional practice guideline Best practice referral, communication and shared care arrangements between psychiatrists, general practitioners and psychologists (PDF; 150 KB). This 2014 guideline was developed by the RANZCP in consultation with the RACGP, psychologists, and mental health nurses. The current information draws upon the principles and processes that formed the basis of the 2014 guideline.

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