Referring to psychological therapy services in Secondary NHS Mental Health Services – how do mental health care professionals decide?

Lucy Fiddick, Emily Neale, Falguni Nathwani, Kristina Bennert, James Gregory

Research output: Contribution to journalArticlepeer-review

3 Citations (SciVal)
123 Downloads (Pure)


Purpose: Evidence-based psychological therapies are available for severe and enduring mental health problems, but resources and access to these are limited within England. Practitioners in community mental health teams (CMHTs) can act as gatekeepers for access to psychological therapies for those in secondary care, but little is known about how they make referral decisions. This paper aims to understand how CMHT practitioners make decisions about who to refer or not, to secondary care psychological therapy services (PTS). Design/methodology/approach: A total of 11 CMHT practitioners were interviewed to understand the decision making processes underpinning their referrals or otherwise, to a PTS within NHS England. The data were analysed qualitatively using thematic analysis. Findings: Thematic analysis resulted in 11 sub-themes under three main themes of the self, the organisation and wider structure and the service user. Results indicated that some participants were referred automatically for psychological therapy if a service user asked or if there was external pressure to refer, while others’ decisions were informed by contextual information such as the service user’s ability to engage or change, risk status and limited organisational resources. Originality/value: This study explores the decision making of multi-disciplinary professionals referring to PTS. The findings have important implications for understanding some of the factors that can influence patient access to psychological treatment in secondary care.

Original languageEnglish
Pages (from-to)185-196
Number of pages12
JournalMental Health Review Journal
Issue number2
Publication statusPublished - 6 Apr 2020


  • Community mental health team
  • Mental health practitioners
  • Psychological therapies service
  • Referral for psychological input
  • Referrals
  • Thematic analysis

ASJC Scopus subject areas

  • Psychiatry and Mental health


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