Title: Referral
Course: Non-Communicable Diseases, Emergency Care and Mental Health Part 2 - Ethiopia (Full)

Referral

Following identification of the mental health problem and giving first aid if the person is injured or has hurt someone else (recall Study Session 7), you will need to refer the person to a health centre. In the case of an emergency situation the person should be referred to a health centre as quickly as possible. Find out who the leader of the family is and give this person the responsibility to get the patient to the health centre. You should accompany the patient whenever possible. Urgent cases need to be referred based on the referral criteria outlined in Box 11.5.

Box 11.5 General criteria for an emergency mental health referral

- Severe illness, violent and unmanageable at home
- History of recent head injury
- Person has fever, severe headache, vomiting or fits
- Person has attempted suicide and is still threatening to commit suicide
- Person has frequent epileptic fits (more than 3 times a day or continuously).
- A mother shows disturbed behaviour following childbirth (see Study Session 13 in this Module and Study Session 3 in the Module onPostnatal Care).

Figure 11.3 A man with mental illness taking his medication.

When the situation is not urgent you can refer the person using the regular referral route. In this case you should send a referral note to the doctor giving all the relevant details you have noted. During your next visit to that family, find out whether they consulted the doctor. If they have not done so, find out the reasons why and encourage them to still do so.