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Declined Referrals: Exploring the Reasons when Specialists and Psychiatrists Sometimes Say No

When Referrals Are not accepted: Exploring the Reasons Specialists and Psychiatrists Sometimes Say No

Having your referral to see a psychiatrist or a specialist declined can be disheartening. It can leave you feeling frustrated, wondering why your path to seeking help has hit a roadblock.

Psychiatrists and other specialists - including the team of Sydney-based specialists here at Dolphin Tribe - are often faced with limited capacity, which means we can't accept every referral we receive.


It's important to recognise that if a specialist does not take you on as a new patient, it’s not a reflection of your worth or the nature of your concerns. We want to stress that the decision is never a judgement on who you are as a person.


In this article, we shed light on the most common reasons psychiatrists turn down a patient's referral and what to do next.

Seven common reasons psychiatrists decline patient referrals

Psychiatrists consider several factors before accepting a patient. While individual circumstances vary, here are some reasons why psychiatrists may refuse a referral.

1. The psychiatrist’s caseload capacity

Psychiatrists have a limit to the number of patients they can see regularly – this allows them to provide the best possible care to their existing patients.

Some psychiatrists will cap the number of new referrals they accept in a month, while others like to ensure they work with a diverse range of conditions. And some patients need long-term, intensive treatment that exceeds the capacity or practice structure of a particular psychiatrist.

At Dolphin Tribe, we understand the importance of timely access to care. We have a team of dedicated practitioners, but there are times when the specialist you were referred to cannot see new patients within a reasonable timeframe. By declining your request, you can find a psychiatrist who has space to offer the treatment you need.

2. Specialty mismatch

Within the field of psychiatry, there are many sub-specialties, including child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, and more. If your referral involves a condition, age, etc. that doesn't align with the psychiatrist's specialty, they may not accept the referral.

This ensures you receive the most tailored and comprehensive care available; after all, you deserve to build a relationship with a psychiatrist who has the knowledge and expertise to best address your unique needs.

3. Medication History


Psychiatrists pay careful attention to the medications a referred patient is currently taking. If the types, combinations, or dosages prescribed by a previous practitioner differ significantly from what the psychiatrist prescribes or is deemed inappropriate, they may need to decline the referral.


4. Lack of relevant information

To provide you with the highest quality of care, psychiatrists rely on detailed information. Without comprehensive details such as a thorough mental health history or a clear reason for seeking psychiatric care, a practitioner won’t know if they are the right fit and may, for this reason, not accept the referral.

5. Geographical distance

If you live a significant distance away from your chosen psychiatrist, attending regular sessions can be challenging - and telehealth is not appropriate for all patients. In such cases, the psychiatrist might turn the patient away, recognising that a closer option with better accessibility will lead to more consistent care and improved treatment outcomes.

6. Urgent care and crisis services

Not all mental health practitioners offer urgent care and crisis services - in these instances, accessing emergency public psychiatric care is more appropriate .


In Sydney, the psychiatrists and psychologists at Dolphin Tribe are not equipped to provide care during a mental health emergency or crisis, and if we have room to accommodate unplanned appointments, we have to prioritise our existing patients.

7. The patient is better suited to the public sector

Some patients, including those who need an integrated team approach, will be better served by psychiatric services offered in the public sector rather than in a private mental health clinic in Sydney. For example, a child may require intensive integrated multi-disciplinary care that includes hospitalisation.

In cases involving a history of violence, the psychiatrist will consider whether their private clinic can safely manage the patient’s needs.

Similarly, if a patient has a history of non-compliance with psychiatric treatment, the public sector may be better equipped to provide the necessary supervision.

8. What to do when a psychiatrist declines your referral

It’s understandable if you feel disappointed your referral to see a psychiatrist has been turned down. You may have heard how important it is to find the right fit and you’ve probably put a lot of thought into choosing a psychiatrist.

Hopefully, you now understand that the decision almost always comes down to the practitioner’s capacity, speciality, and even location. It is never based on who you are as a person and if the decision is centred around your specific needs, it’s only because we want to make sure you’re working with the most well-suited therapist.

The next step is to carry on in your quest to find a psychiatrist who can lead your care effectively. Search for local Sydney psychiatrists on the Your Health in Mind website, or book a consult with your GP or referring practitioner for alternative options. Remember, you can approach any other psychiatric specialist in the field – you aren’t limited to the named person on your referral.



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