Making the referral
When you have identified a need for referral, you may need to follow up by contacting suitable services, and making arrangements for the referral. Always check your organisation's policy and procedures regarding referrals, as you must comply with these.
Contact suitable services
To assist you in selecting the most appropriate service, you may need to obtain a range of information. For example, you need to:
- establish whether there are vacancies, or how long the waiting list is
- provide sufficient non-identifying information on your client's situation and needs
- confirm that the referral of this client is appropriate and that a relevant service can be provided
- discuss what the service can provide and obtain information about participation of your client
- clarify any obligations in relation to you or your client (e.g. resources required such as transport, charges, etc.)
- discuss monitoring of progress, sharing of information and confidentiality
- discuss details and provide additional information required by the service
- identify the other agency's referral protocols, e.g. ask if a written report is required and what form that will need to take.
Ensure that any referrals are in line with agency policy and documented as required.
You will need to make clear arrangements in terms of documentation, appointments, costs and travel. Consider the requirements regarding:
- referral documentation to be provided
- checking and confirming arrangements with referral agency
- ensuring the client understands the referral requirements
- timing of other commitments that you and your client have
- funds required and how you or your client will access these
- how your client might travel to and from appointments.
Do not to commit to any requirement that cannot realistically be met either by you or your client.
Clients may need to be given enough initial information to access the service and then ongoing updates of information to maintain their commitment to working with a particular program or service. They may need support in attending services; it is not always easy to maintain a commitment to attending a service, particularly if it involves discussion of personal issues.
It is important that you encourage attendance. You can do this by:
- discussing progress
- listening to difficulties and assisting your client to manage these
- following up any problems which require your input or for which your client needs advocacy.
If your client lacks confidence or is unable to clearly communicate their needs, you may need to consider:
- planning an initial visit to the referred agency, or attending the first appointment along with the client
- ensuring that the client has the opportunity to provide as much information as they can to the agency
- providing the client with as much information as possible to take charge of the process from that point on with your minimal support
- encouraging the client to provide feedback on the quality of the service and ways that the service may or may not be meeting their needs.
What you intend as encouragement may sometimes be seen as intrusion. Always take the lead from your client. If unsure, check if they would like to talk. If they don't, respect their wishes and remind them that you are available if they wish to talk later.
When referring a client to another service or organisation:
- As a support worker, your role will involve providing these supports as part of your duty of care to your client (including the continuing provision of information) to empower clients in the use of services/programs.
- A primary need and basic right for any client is to be treated with dignity and respected as an individual at all times.
- Support for the referral process would depend on individual need. It is important to discuss with the client your concerns and seek her perceptions of how she is progressing. This hopefully will lead to her agreeing with the need for specialist help and raising her motivation to work with the psychiatrist.
- The next step could be researching available psychiatrists in the area and seeking feedback from other consumers about the quality of service, etc.; you could share this information with the client to inform a final decision.
- Once the referral appointment is made, the worker and client will agree on the content of a referral letter and the worker would discuss who, if anyone, the client would like to accompany her to the first appointment.
- Where appropriate to the case plan, the worker would monitor the client's progress with these specialist appointments and record this feedback in the case records.
Read the case study below and answer the questions that follow. Enter your response into the text box provided.
As part of your caseload, you support Naomi, a person with depression. At times, she appears confused, distressed, passive or angry, depending on her family circumstances at that time. Her current mental state and prescribed medication can significantly influence her ability to communicate.
You have been concerned about the chronic nature of her depression and have talked with her about seeing a psychiatrist. She has agreed, but clearly needs you to support her through the process.
In what ways might you support a client like Naomi through a referral to a psychiatrist? How should she be treated, and what practical steps would you take to support the process?
You must treat your client with dignity and respect at all times. Steps you could take to support the referral process include identifying suitable services, making arrangements and supporting participation:
- Research available services in the area, and seek feedback about the quality of service.
- Provide information and discuss the options with the client.
- Prepare a referral letter in consultation with the client.
- Ask the client if she would like anyone to accompany her to the first appointment.
You may have suggested other steps appropriate to your work situation, such as monitoring the client's progress with the specialist.