Riverview Hospital admission referral form [pdf, 60 Kb]
Admission is by physician referral only, and must meet the admitting criteria for Riverview Hospital's Adult Tertiary Psychiatry Program. The program's intake team will review each referral for admission/transfer within one week of complete documentation being received (or within 24 hours for Psychiatric Intensive Care Unit admissions). If necessary, patients accepted for admission/transfer will be waitlisted in chronological order of their referral date.
General Admission Criteria
The following criteria apply to acute tertiary and rehabilitation services. They are subject to change according to community needs, bed availability, and available expertise.
Inclusion Criteria:
1. Diagnosis: Primary diagnosis is DSM-IV Axis I
• Psychotic disorder
• Affective disorder
• Axis I diagnosis of Substance Abuse/Dependence is co-morbid with either of the above and not the primary diagnosis.
2. Disability: High degree of disability i.e. GAF < 50.
3. Age: Generally between 17 and 64, inclusive.
4. Resources: Given criteria 1, 2 and 3 …
• Unable to be managed in the community with current resources;
• Referring hospital has made a satisfactory effort to treat the patient;
• The patient is medically stable at the time of transfer to Riverview Hospital.
5. Referral Sources: Inpatient psychiatric units and psychiatric assessment units of general hospitals.
6. Discharge Plan: Must accompany the request for admission.
7. Discharge Summary: Must accompany the patient.
Exclusion Criteria:
1. Axis I diagnosis is primarily a psychotic disorder due to a general medical condition or a substance-induced mood/psychotic disorder.
2. IQ is below 70.
3. The primary clinical problem is related to an Axis II diagnosis or behavioural problem.
4. Acquired brain injury; Dementia and other cognitive disorders.
5. Pervasive developmental disorders (ie., Asperger, Autism, etc.)
Psychiatric Intensive Care Unit (PICU) Admission Criteria
All of the above and:
1. Patient must have an Axis I diagnosis of Schizophrenia or other psychotic disorders, or mood disorder.
2. Patient must present with behavioural disturbances of extreme proportions (such as severe risk to self or others, or extreme disorganization and agitation), and these disturbances cannot be managed in the current inpatient setting. Patient also presents as an aggressive elopement risk (is likely to use violence to achieve same).
3. The patient is validly certified under the Mental Health Act and will be transferred under Section 35 of the Act.
4. The patient’s behaviour must NOT be due to a primary diagnosis of a “mental disorder due to a general medical condition” or “substance-induced disorder” (DSM-IV).
5. The patient must have a complete psychiatric and medical assessment performed prior to admission and this information will be provided upon admission. The patient must be medically stable prior to transfer to the PICU.
6. The referring agency or program guarantees that the patient will be accepted back to its care as soon as RVH determines that the patient is ready to be returned.
7. Referrals will only be accepted from inpatient psychiatric units of general hospitals. Referrals will be accepted from Emergency Rooms or Psychiatric Assessment Units provided there is agreement by the referral source that the patient will be accepted back when the patient is determined to be ready for discharge from the PICU.
Refractory Research Program Admission Criteria
1. Must meet the general admission criteria to the Adult Tertiary Psychiatry Program.
2. Either meet the criteria for a specific investigational protocol for drug and psychiatric research, or
3. Have an initial presentation of atypical psychosis or refractory psychosis that requires extensive investigation as well as monitoring and treatment.