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Table 2 Content of referral letters for the four most common primary referral diagnoses

From: Referral patterns to outpatient child and adolescent mental health services and factors associated with referrals being rejected. A cross-sectional observational study

  Affective disorder Anxiety disorder ASD ADHD/ADD
N % N % N % N %
255 (14.0) 212 (11.6) 409 (22.4) 509 (27.9%)
Sociodemographic characteristics
 Boys 80 (31.4) 84 (39.6) 311 (76.0) 338 (66.4)
 Referral age, median (IQR) 16.1 (14.5–17.1) 14.8 (12.1–16.4) 10.7 (7.2–14.1) 10.6 (8.0–14.8)
 Placement in care 16 (6.3) 6 (2.8) 15 (3.7) 38 (7.5)
Referral source
 - General Practitioner 288 (89.4) 164 (77.4) 93 (22.7) 177 (34.8)
 - Other medical doctor 15 (5.9) 23 (10.8) 48 (11.7)   (10.6)
 - Educational psychologist 7 (2.8) 20 (9.4) 239 (58.4) 54 (47.7)
 - Case worker social services 5 (2.0) 5 (2.4) 29 (7.1) 243 35 (6.9)
Previous support/interventions
 Combined (school, psychosocial and healthcare) 173 (67.8) 159 (75.0) 385 (94.1) 457 (89.8)
 In school
  - Extra attention from teacher 16 (6.3) 17 (8.0) 22 (5.4) 35 (6.9)
  - Educational psychologist involved 37 (14.5) 41 (19.3) 193 (47.2) 206 (40.5)
  - Part time support teacher in class ≤4 (≤1.6) 9 (4.3) 48 (11.7) 62 (12.2)
  - Full time special needs education 18 (7.1) 26 (12.3) 93 (22.7) 112 (22.0)
 Psychosocial
  - For the child 105 (41.2) 89 (42.0) 76 (18.6) 86 (16.9)
  - For the parents 14 (5.5) 10 (4.7) 48 (11.7) 82 (16.1)
  - For both the child and parents 5 (2.0) 6 (2.8) 9 (2.2) 18 (3.5)
 Healthcare
  - Allied health professionals 4 (1.6) 7 (3.3) 97 (23.7) 73 (14.3)
  - Medical doctor 44 (17.3) 55 (25.9) 108 (26.4) 135 (26.5)
Description of cognitive level
 - Academic level 37 (14.5) 39 (18.4) 31 (7.6) 37 (7.3)
 - Cognitive testing 11 (4.3) 32 (15.1) 281 (68.7) 321 (63.1)
Impact on schooling
 - Academic problems 12 (4.7) 6 (2.8) 83 (20.3) 138 (27.1)
 - Absence on some days 46 (18.0) 37 (17.5) 48 (11.7) 68 (13.4)
 - Complete school absence 34 (13.3) 45 (21.2) 41 (10.0) 19 (3.7)
Self-harm and suicidal ideations
 - Self-harm 20 (7.8) 7 (3.3) 21 (5.1) 25 (4.9)
 - Suicidal ideations 105 (41.2) 18 (8.5) 29 (7.1) 26 (5.1)
 - Self-harm and suicidal ideations 51 (20.0) 4 (1.9) 9 (2.2) 14 (2.8)
  1. ASD Autism Spectrum Disorders, ADHD/ADD Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder