Every psychologist in this region is triaging. That means the referral letter is not a formality, it is the document your patient is triaged on. A referral with four useful lines will place someone more accurately than a template with four hundred words of history.

This is not a complaint about referral quality. It is a note on which specific details change a triage decision, written from the receiving end.

The five things that actually move triage

Risk, stated explicitly. Current suicidal ideation, self-harm within the last three months, any history of attempt. If risk is nil, say nil. An absence of comment is ambiguous and I have to assume the higher end of it, which slows everything down while I chase you.

Duration and trajectory. Six weeks of low mood after a redundancy and six years of it are different referrals. Getting worse, plateaued or improving matters as much as severity does.

Function. The single most useful line in any referral is what the patient has stopped doing. Not attending work since March. Withdrawn from the footy club. Year 11 attendance down to two days a week. It tells me more about severity than a scale score.

Previous treatment and what happened. Including treatment that failed, and if you know why. “Six sessions of CBT last year, disengaged after three” is genuinely valuable and shapes how I would approach it.

Medication. Current agents, doses, when started, and adherence if you know it. Recent changes especially.

What to include for specific presentations

For a suspected eating disorder: weight history and trajectory rather than a single figure, any compensatory behaviours, and recent bloods and ECG if done. Please also consider whether an Eating Disorder Management Plan is appropriate rather than a standard plan, since it releases up to forty psychological sessions instead of ten.

For trauma: you do not need to document the detail, and your patient will usually be glad you did not. Type and timeframe is enough. Single incident or developmental, childhood or adult, and whether they have talked about it before.

For adolescents: who has custody and who is consenting, school engagement, and whether the young person actually wants to attend or has been sent. That last one changes my whole approach to the first session.

What you can safely leave out

Full past medical history unless relevant. Long verbatim quotes. Lists of every stressor ever disclosed. A five-paragraph narrative takes me longer to triage than a short structured note, and rarely contains more of the information above.

Name the psychologist

A plan addressed “To whom it may concern” is valid, but if the patient has already chosen someone, addressing it to them directly removes an administrative step and prevents the plan being used elsewhere and then needing reissue.

Please also make sure the referral date and your provider number are on it. A surprising proportion of delays come from a missing provider number, which cannot be fixed at my end.

Tell the patient what to expect

Two sentences from you saves considerable confusion later. That the plan covers six sessions with a review to release another four, ten in a calendar year. And that there is a gap payment.

Patients frequently arrive believing sessions are free, and finding out otherwise at reception is a poor start. My fee is $225 with a $141.85 rebate, so the gap is $83.15. The fees page has the detail if you would rather point them at it.

If it is urgent

Mark it clearly and ring rather than relying on the letter. A referral marked urgent inside a standard batch may not be read for several days.

For acute risk, this is not the right pathway. Grampians Mental Health and Wellbeing Services triage is 1300 247 647, and emergency presentations should go to the emergency department.

Sending it

Referrals can be faxed to +61 3 7048 3839, which is kept for exactly this, or emailed. The referrals page has a short form if that is easier than a letter.

If you are weighing up whether a patient needs a clinical psychologist specifically, there is a companion piece on that.