Unsure whether a referral is appropriate?

When to refer to a healthcare professional

Occupational Therapy

Mental health dx

  • Anxiety
  • Depression
  • Stress
  • Trauma
  • Grief
  • Low self-esteem

Behavioural

  • Increased irritability 
  • Increased feelings of sadness or overwhelm 
  • Withdrawl from social activities

Signs of Psychological Distress

  • Decline in performance at work or school 
  • Withdrawal from social relationships and activities 
  • Changes in weight and appearance, including negligence of personal hygiene A cluster of signs can be grouped into personal life, professional life, behavioral plus emotional, physical, and safety risk indicators for distress
  • Disturbances in sleep, either oversleeping or difficulty falling or staying asleep

Behaviour (if associated with difficulties in previous columns) 

  • Difficulty coping with emotions such as stress, anger
  • Difficulty with daily life skills such as meal preparation, money skills, chores
  • Difficulty maintaining personal hygiene and presentation
  • Difficulty managing time
  • Difficulty maintaining a healthy lifestyle
  • Difficulty solving problems
  • Low self esteem
  • Inappropriate or immature behaviour
  • Difficulty attending/ concentrating
  • Overactive
  • Underactive
  • Poor social skills
  • Reluctant to new and/or challenging tasks
  • Limited leisure activities

Dietetics

Weight

  • Unplanned weight loss or gain in the last 3-6 months
  • Falling Body Mass Index (BMI)
  • Failure to thrive (Children are diagnosed with failure to thrive when their weight or rate of weight gain is significantly below that of other children of similar age and sex)
  • Noted weight concern from others

Nutrition intake

  • Trouble transitioning from liquids to solids
  • Noted lack of interest in certain food types
  • Excessive energy intake (ie. lack of satiety)
  • Low levels of nutrients noted during blood analysis (ie. iron deficiency, B12 deficiency)
  • Noted avoidance of macronutrients (protein, carbs, fats)
  • Texture modified food needs (ie. dysphagia) 
  • Lack of variety in diet
  • <10 food types eaten

Education

  • Lack of general nutrition literacy in family
  • Lack of general health literacy in family or for child
  • Noted misinformed nutrition knowledge (ie. believing carbohydrates are ‘bad’ for you)
  • Discussion of ‘bad foods’, ‘naughty foods’

Unmanaged ailments

  • Diabetes
  • Coeliac disease
  • Renal disease
  • Liver disease
  • Irritable bowel disease
  • Interolances
  • ARFID
  • Diverticular disease
  • Eating Disorders & Disordered eating

Gastrointestinal

  • Bloating/gas/stomach discomfort 
  • Mucus in stool
  • Cramping/stomach pain
  • Constipation/Diarrhea 
  • Reflux 
  • Straining upon bowels opening
  • Pain upon BM
  • Bloating 
  • Intolerances/Allergies

Behavioural

  • Decreased interest in food (apathy)
  • Beginning to diet at an innappropriate age
  • Weighing self frequently 
  • Preoccupation with food 
  • Irritability around meal time 
  • Signs of purging (ie. vomiting, excessive exercise, laxative use)
  • Inappropriately restricting intake in attempts to lose weight.
  • Hoarding food/overconsuming at certain parts of the day/ hiding food
  • Problem/fussy eating (not enjoying certain texures/colours/foods touching)
  • Anger at others eating certain foods or at certain times 
  • Regimented meal times/rules round meal times

Weight

  • Unplanned weight loss or gain in the last 3-6 months
  • Falling Body Mass Index (BMI)
  • Noted poor relationship with weight
  • Noted weight concern

Nutrition intake

  • Reduced nutritional intake (causing for concern)
  • Noted apathy towards food
  • Increased nutritional intake (excessive intake)
  • Low levels of nutrients noted during blood analysis (ie. iron deficiency, B12 deficiency)
  • Noted avoidance of macronutrients (protein, carbs, fats)
  • Texture modified food (dysphagic patients) 
  • Impaired fasting glucose resulting from inappropriate carbohydrate intake

Education

  • Lack of awareness around current medical condition and nutritional implications (ie. Diabetes, Coeliac disease, Renal disease, Liver Disease, Food inter)
  • Lack of general nutrition literacy 
  • Lack of general health literacy 
  • Noted misinformed nutrition knowledge (ie. believing carbohydrates are ‘bad’ for you)

Unmanaged ailments

  • Diabetes
  • Coeliac disease
  • Renal disease
  • Liver disease
  • Irritable bowel disease
  • Diverticular disease
  • Eating Disorders & Disordered eating

Gastrointestinal

  • Bloating/gas/stomach discomfort 
  • Mucus in stool
  • Cramping/stomach pain
  • Constipation/Diarrhea 
  • Reflux 
  • Straining upon bowels opening
  • Pain upon BM
  • Bloating 
  • Intolerances/Allergies

Disordered eating

  • Noted poor relationship with food / concerned abour relationship with food
  • Decreased interest in food (apathy)
  • Preoccupation with food 
  • Irritability around meal time 
  • Signs of purging (ie. vomiting, excessive exercise, laxative use)
  • Inappropriately restricting intake in attempts to lose weight.
  • Hoarding food/overconsuming at certain parts of the day
  • Problem/fussy eating (not enjoying certain texures/colours/foods touching)

Psychology & Counselling

Mental health dx

  • Generalised Anxiety Disorder
  • Major Depressive Disorder
  • Attention Deficit Disorder
  • Anxiety Disorders (OCD)
  • Personality Disorders (BPD)
  • Low self-esteem

Behavioural

  • Noted increased irritability 
  • Teary / feelings of sadness at inappropriate times
  • Lashing out at others / heightened anger 
  • Irritable when unable to complete tasks when planned/ interrupted
  • Feelings of overwhelm/ impending doom

Signs of Psychological Distress

  • Decline in performance at work or school 
  • Withdrawal from social relationships and activities 
  • Changes in weight and appearance, including negligence of personal hygiene
  • A cluster of signs can be grouped into personal life, professional life, behavioral plus emotional, physical, and safety risk indicators for distress
  • Disturbances in sleep, either oversleeping or difficulty falling or staying asleep
  • Noted suicidality

Situational

  • Bereavement from loss of job or relationship
  • Injury or chronic illness management
  • High stress working or family life
  • Current caregiver
Dialectical Behaviour Therapy

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