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West London NHS Trust > Services > GPs and referrers > Adult referrals

Adult referrals

All adult referrals are now made through our single point of access.

For all urgent or emergency referrals, please call 0300 1234 244 so that your referral can be appropriately triaged.

Referrals forms should be emailed to wlm-tr.wlmhtSPA@nhs.net.

We no longer accept faxes.


Referral guidance

Referral to secondary mental health services should be considered in the following circumstances:

General demographic criteria

  • Age 18 or over.
  • Resident within the London Borough of Ealing, Hammersmith & Fulham or Hounslow.

Routine referrals

  • Anxiety/depression where 2 antidepressants and psychological input (NICE guidelines) have been prescribed with little or no improvement or intolerance.
  • Moderate to severe mental health condition e.g. severe anxiety/depression (where it is identified as above), bipolar disorder, schizophrenia.
  • Enduring Personality Disorder, i.e. that which gives rise to a history of severe social disability, long term risk of self-harm, self-neglect or a serious long term risk of danger to others
  • Where the GP requires the expertise of secondary care to confirm a diagnosis or to implement or refer for specialist treatment.

Risk / quality of life

  • Immediate action is not required (if it is, then urgent / emergency referral required)
  • There may be safeguarding concerns (for children or vulnerable adults) related to mental health, but urgent / immediate action is not required
  • Where mental health problems will lead to progressive deterioration of the level of functioning without intervention from the Mental Health Services

Other factors

  • Where this is a recurrent episode (within the last year) – ie re-referral
  • Where discussion on the Consultant phone line has confirmed that referral is appropriate
  • Where primary care interventions and voluntary/non-statutory options have been exhausted
  • Mental health problems where an assessment is requested under the Community Care Act 1990.

Urgent referrals

  • General demographic criteria as above (age, residence etc)
  • Criteria as for routine plus any of the following
  1. Actively suicidal ideas or plans, with clear means, and/or history of such attempts.
  2. Psychotic symptoms including delusions, hallucination and/or thought disorder
  3. Severe agitation accompanying anxiety or depression
  4. Associated with sufficient functional impairment that there is a risk to their own or others’ safety through direct harm or neglect.

Direct harm: patient feels so threatened by others that they have thoughts of and intent of harming others or themselves. Alcohol use, lack of safety factors and a clear plan with preparation increase the level of risk.

Self-neglect: patient’s physical situation or level of psychological distress is found to be intolerable or they are at risk due to being vulnerable to others for example through disinhibited behaviour in mania

5.  Where serious safeguarding concerns (for children or vulnerable adults) appear related to mental health

Emergency referrals

  • General demographic criteria as above (age, residence etc)
  • Criteria as for urgent plus any of the following
  1. Presence of command hallucinations
  2. Immediate intent and means to harm self or others
  3. No other means to temporarily mitigate risk (eg no carers to accompany patient)
  4. Where serious and immediate safeguarding concerns (for children or vulnerable adults) appear related to mental health
  5. Any other mental health crisis where an assessment is required under the Mental Health Act