What are the key indicators for referring a patient with schizophrenia to secondary mental health services?

Key indicators for referring a patient with schizophrenia to secondary mental health services include:

• First presentation of sustained psychotic symptoms lasting 4 weeks or more, requiring urgent referral to specialist mental health services such as early intervention in psychosis services or CAMHS for children and young people ⁴.
• Presence of distress, decline in social functioning, transient or attenuated psychotic symptoms, or other behaviours suggestive of possible psychosis, or having a first-degree relative with psychosis or schizophrenia, warranting assessment without delay by specialist mental health services ¹.
• Ongoing symptoms, impaired functioning, or distress after initial treatment where a clear diagnosis of psychosis cannot be made, requiring regular monitoring and possible referral for specialist assessment ¹.
• Risk factors such as immediate risk of harm to self or others, mania, severe depression, or relapse in known psychiatric conditions, which necessitate urgent or same-day specialist assessment ².
• Failure to respond to behavioural support plans or presence of severe or complex needs, indicating the need for specialist mental health input ³.

Referral should be made promptly to ensure comprehensive multidisciplinary assessment and management by trained specialists, including consultant psychiatrists ¹,⁴.