Liaison and referral

Referral to secondary mental health services is advised:

• as an emergency if very vulnerable, eg if there is significant risk of suicide or disruptive behaviour
• urgently if significant symptoms continue or escalate despite treatment.

Non-urgent referral or advice from specialist worker is recommended:

• for assessment, care planning and allocation of key worker under the Care Programme Approach
• before starting lithium
• for medication review and for other treatment strategies, eg cognitive behavioural therapy
• because of lithium’s teratogenicity, for preconceptual counselling or contraception advice; for all women with a history of bipolar disorder to plan prevention and management of high risk (up to 50%) of puerperal psychosis.
  

Last edited: 20/8/2003

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