The size of demand for specialized neuropsychiatry services: rates of referrals to neuropsychiatric services in the South thames region of the United kingdom.

The authors assessed the number of referrals to neuropsychiatry services covering South London, Kent, Surrey, and Sussex (population 6,887,000) over a 2-year period. The average referral rate was 11.2 per 100,000 per population for each year. Geographical distance from the specialist provider strongly affected referral rates, with clinicians in South London making more referrals than those from outside London. Assessment of appropriateness of referrals indicated that more than 86% of referrals were highly appropriate, and thus the higher level of referrals from close proximity cannot be attributed to inappropriate referrals. A survey of clinicians reported lower awareness of services and how to access these services among those clinicians working at a greater distance from the service provider, which likely results in unmet needs. Greater attempts should be made to improve access to neuropsychiatric services for clinicians who do not practice within close proximity of a specialist neuropsychiatry service.