Mental Health Referrals From Behavioral Wellness Practitioners
A behavioral approach typically isn’t the right form of support when someone’s mental health difficulties escalate to a crisis. It also usually isn’t the route to take when mental health issues have an unclear or complex root cause or are due to external circumstances. In these cases, practitioners will need to make a referral to the most appropriate service.
This process can vary between organizations and will differ depending on the presenting problem of the person being referred. There are also some accessibility and data protection issues to consider when making a referral.
To help you better understand the mental health referral process, this article will clarify:
- The reasons someone might need a different approach or service to behavioral
- How the referral process can work
- The different kinds of services you might refer someone to
When to Refer Someone From Behavioral Wellness
The behavioral approach is a powerful, practical, and educational way to support wellness and overall lifestyle changes. It can provide people with a significant understanding of how their daily thoughts, decisions, and actions impact their health, empowering them to take back control.[1]
However, behavioral health does have its limitations. Sometimes those who receive care in this form find it hard to deal with the power dynamic of ‘Educator/Expert and Learner/Patient’. For instance, they may feel patronized and like a behavioral approach places blame on them. Furthermore, if there’s trauma in someone’s past, they may feel a behavioral approach doesn’t explore it deeply enough.[1], [2][2]
Many behavioral wellness providers are limited in their time and resources, which also makes it difficult to support clients who need more intensive or frequent care. Additionally, they may also encounter clients whose difficulties are genetically determined, calling for medical interventions.[1], [3]
Given these limitations, certain people will hugely benefit from being referred by a behavioral wellness practitioner to another service. These clients include those who…
Have Experienced Trauma
Traumatic experiences can “rewire” the nervous system, making it very difficult to manage emotional distress. People with traumatic histories may need trauma-informed psychotherapy that pays more attention to emotions and assists people in processing painful memories.[4], [5]
Are in Crisis
Since behavioral healthcare is often provided in community and low-risk settings, they don’t tend to have the capacity to support people in crisis. So when someone suddenly becomes very unwell or unable to look after themselves, or poses a risk to themselves or others, they should be referred to a crisis service.
Experience Complex or Unclear Difficulties
Psychodynamic therapy tends to work better than behavioral health when someone’s presenting problem is unclear or complex.[6] For example, in the case of non-biological sexual issues, existential anxiety, and relationship problems.
These challenges can be explored more deeply with a therapist who works with the unconscious and transference/countertransference.[6] This is because psychodynamic therapy allows much more time for the underlying factors to emerge through talking and developing trust.
Furthermore, people with conditions like high-functioning depression are often still able to get on with their daily tasks. Therefore, a behavioral approach is unlikely to be relevant for them because these people don’t need support with their behavior. Instead, they’ll more likely benefit from therapy that allows them to talk through their mood and past life experiences.
Are Experiencing Grief or Questioning Life’s Purpose
Occasionally, someone who’s grieving or experiencing existential questions will report mental health difficulties and end up in a behavioral health service.
Humanistic and existential therapies place more emphasis on the client’s self-direction, inviting them to reflect on their own beliefs about life, death, meaning, and what makes a meaningful life. Behavioral health isn’t really set up to explore this subject matter, as it’s not really about lifestyle decisions.[7]
Have Severe Mental Health Conditions
Some mental health conditions, such as bipolar disorder, psychosis, or schizophrenia, have biological and neurochemical causes. If someone’s experiencing extreme fluctuations in mood or hallucinations, they cannot be treated with a purely behavioral approach.
Those experiencing these conditions will need to be referred from behavioral wellness services to medical and psychiatric care providers. Here, they can be prescribed medication, be stabilized, and receive more intensive care.
Are Finding It Hard to Cope Due To External Circumstances
If someone’s mental health difficulties stem from things like poverty, homelessness, or an abusive living situation, behavioral health likely won’t be the best form of support for them. It may even feel invalidating to encourage people in these circumstances to change their thoughts and behaviors.
In these cases, behavioral wellness practitioners should refer patients to specialized support services, such as those with expertise in domestic violence or homelessness. There, they can receive more practical support from multidisciplinary teams.
How Does the Mental Health Referral Process Work?
Depending on your organization, the patient’s difficulties, and the type of service you’re referring them to, the process can vary. However, for the best health outcomes, it’s important to include the person in decision-making as much as possible.[8]
Here are some things to consider and what you can expect from the process:
Accessibility Considerations
Many referrals will need to consider specific accommodations such as disability access, cultural competence, and languages spoken. When these factors aren’t considered, they can be barriers for people seeking support.
Make sure you keep these needs in mind when looking at referral options so that the person you’re referring can truly access the service.
Recommended Guidelines
When it’s time to refer a patient to mental health services, your organization should have guidelines you can follow. If it doesn’t, you might wish to raise it as something to be developed, so that future referrals can go smoothly.
Behavioral health referral guidelines typically include:[9]
- Assessing someone’s needs and experience of previous treatments
- Carrying out a risk assessment
- Identifying treatment objectives
- Evaluating the services you can offer them and whether they’ll be adequate
- Surveying local services that could be a better fit
- Documenting pre-referral efforts
- Obtaining the patient’s (or their family’s) consent to make a referral
- Tracking the referral and following up (within data protection regulations)
Crisis Referrals
While the above is a rough guideline for making a referral, crisis and psychiatric referral processes will be slightly different. You’ll be under greater pressure to complete the referral quickly and keep the person safe until they are receiving crisis support.
There are several routes you can take when making a crisis referral. Options include:[10]
- A 24-hour crisis hotline, like 988
- Walk-in crisis clinics
- Mobile crisis teams
- Respite centres
- Crisis stabilization units
- Extended observation units
- Emergency room
- Hospitalization (partial or full)
When carrying out a crisis referral, you won’t have time to do a full assessment. You’ll need to quickly determine urgency, communicate sensitively with the person in crisis, and make contact with a service. After, you can then record the event in your organization’s records and consider a follow-up referral if needed.
Necessary Details
When putting together your referral, you should include all the key pieces of information about the patient or client. This should include:
- The urgency level
- Any safety risks you’ve identified
- The person’s presenting problem, symptoms, and duration
- Current medications and allergies, if applicable
- Their social context, such as legal issues, caregiving responsibilities, and housing status
Once you’ve compiled the necessary information, you’ll send your referral via email, telephone, or a specific online portal.
What Services Might You Refer To?
Mental health care coordination can involve a broad range of services. So your knowledge of what’s locally available will be an asset to this process. Plus, your decision will likely be swayed by the person’s specific needs, preferences, and risk level.
The following are services you could refer to:
- Crisis services: An urgent referral may be necessary if you have good reason to believe there’s a risk of significant harm, whether that’s to self or others. These services are well-prepared for de-escalation, continuous monitoring, and keeping people safe.[11]
- Inpatient services: Similarly, inpatient services are for those who need intensive treatment and continuous monitoring. Crucially, crisis services usually help people avoid inpatient services, though they’re necessary for high-risk circumstances.
- Outpatient care: Outpatient care involves a broad spectrum of services, including community clinics, primary care doctors, and private therapy practices. These are helpful for those people who don’t need residential care. When referring patients to outpatient mental health services, the specific choice will depend on the person’s presenting problem. For example, some clinics specialize in addiction issues, while others might focus on domestic abuse, trauma-informed therapy, and so on.
- Counseling and psychotherapy: As mentioned, there are many specialist providers of counseling and psychotherapy available. So, it’s a good idea to have a network of therapists for your referrals in mind so you can recommend the appropriate one based on someone’s specific difficulties.
- Telehealth therapy: For working professionals or those who simply prefer it, online therapy is an accessible and comfortable option. Delivered via video or telephone call, telehealth can include a wide range of therapeutic approaches and be ideal for those who want privacy or have busy schedules.
It’s also a good idea to be aware of affordable mental health treatment options so that your referrals can be inclusive of those on low incomes.
Mission Connection: Collaboration With Behavioral Health Providers
At Mission Connection, we can support clients coming from behavioral health services in several ways. We treat people with a wide range of mental health conditions from multiple facilities, as well as our online therapy option.
Not only do we accept outpatient mental health referrals for many types of psychotherapy, but we also provide partial hospitalization treatment for those needing deeper levels of care.
We welcome referrals from behavioral wellness practitioners, as well as self-referrals from those worried about their own mental health. Take a self-assessment quiz to make sense of your symptoms or contact us today to learn more.
