When should I consider referring a patient with psychosis to secondary mental health services?

Refer a patient with psychosis to secondary mental health services if there is a poor or partial response to treatment, treatment adherence is poor, or their functioning declines significantly ¹.

Refer if the patient develops intolerable or medically important adverse effects from medication ¹.

If there is suspected comorbid alcohol or drug misuse, or potential risk to the person or others, secondary care referral is indicated ¹.

Additionally, refer if the person is pregnant or planning a pregnancy ².

In cases of suspected psychosis or if in the prodromal phase, refer without delay to specialist mental health services or early intervention in psychosis services ¹,².

Re-refer if the person’s social functioning declines, or if they experience persistent symptoms, distress, or impairment despite initial management ¹.