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--Risk of Suicide or Self Harm

--Risk of Violence to Others (notify appropriate authorities and potential victims when required)

--Cognitive Disorganization or Acute Cognitive Changes (thought processes)

--Substance Abuse (substance abuse clinician)

--Child Abuse (notify appropriate authorities when required)

--Urgent Life Issues or Emotional Crises Requiring Rapid & Integrated Treatment

* Referral to a specialized evaluator is indicated whenever these phenomena are present and are beyond the expertise of the initial evaluator.Always consider possible need for urgent referral.

Other Indications for Psychiatric Referral

--Support During an Emotional Crisis

--Interpersonal or Personality Issues

--Less Than Full Remission (inadequate treatment response)

--Reconsidered or More Definitive Diagnosis or Treatment Planning

--Troublesome Patient or Clinician Emotions (that interfere with treatment)

--Significant Co-Occurring (or potentially contributing) Medical Illness

--Distressed Executives (heightened confidentiality concerns)

--Management Consultation Issues

--Long-term Life and Lifecycle Issues

--Concerns About Suicide or Violence

August 1, 2008

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