Psychiatry Consult 🧠
Guide for psychiatry consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: name, DOB, MRN, current location
- Presenting problem: suicidal ideation, psychosis, agitation, low mood, etc.
- Timeline: onset, progression, recent triggers or stressors
- Mental Health History: prior diagnoses, admissions, medications
- Medical History: comorbidities, substance use, head trauma
- Current Medications: especially antipsychotics, antidepressants, benzos
- Collateral history: from family, carers, nursing staff if possible
- Capacity concerns and any risks to self or others
🔎 Investigations to Know
- Vital signs – especially if agitation or overdose suspected
- Recent bloods – U&E, LFTs, glucose, TFTs, tox screen if OD suspected
- ECG – especially if on QT-prolonging drugs or overdose
- Any relevant imaging (e.g. CT if new confusion or head trauma)
📞 Example Script
- Hi, this is [Your Name], the intern from [Team Name]. I'm calling for a psych consult for a [Age]-year-old [M/F] with [e.g. suicidal thoughts/agitation/new psychotic symptoms].
- They have a background of [e.g. depression, schizophrenia], and are currently [describe behaviour or mental state briefly].
- Vitals are [brief summary], recent bloods are [summary], and they've been medically cleared for psych review.
- We’re hoping for a review to assess mental state, risk, and advise on management or transfer options.
📝 Tips
- Always consider medical causes first: delirium, sepsis, drugs
- Check for safety: risk to self, others, or staff
- Document your assessment clearly (MSE, risk, capacity)
- If urgent, flag to psych team directly and ensure nursing supervision
- Have collateral history ready where possible