Investigating factors that influence genetic counselors’ decisions to refer patients to mental health providers

• Published in: Journal of genetic counseling 2022-10, Vol.31 (5), p.1113-1124
• Main Authors: Hayes, Taylor, Cunningham, Mitchell, Trepanier, Angela
• Format: Article
• Language: English
• Subjects: Barriers; Community resources; Counselors; Email; Genetic counseling; Genetic counselors; Health insurance; Insight; Medical referrals; Mental disorders; Mental health; Patients; Polls & surveys; Psychological distress; psychosocial assessment; Psychosocial factors; Psychosocial support; Response rates; Social interactions; Social support; Surveys
• ISSN: 1059-7700; 1573-3599
• DOI: 10.1002/jgc4.1582

Genetic counselors (GC) serve patients who are often in distress at the time of their consultation. GC competency includes providing short‐term, client‐centered counseling, while using community resources, such as mental health providers (MHPs), for psychosocial support. The purpose of this study was to assess the mental health referral practices of GCs; specifically, the rate of referrals, factors influencing a GC’s decision to refer, and barriers to referrals. GCs working in direct patient care for at least one year were recruited to take a novel 27 question survey created based on the results of a previous qualitative study. A link to the web‐based survey was distributed through the National Society of Genetic Counselors Student Research Program and American Board of Genetic Counselors by email. A total of 144 individuals opened the survey for an estimated response rate of 3%. A majority of respondents (54.3%) reported they assess a patient's need for a mental health referral at least half of the time. The mean number of referrals made in the past 12 months was 5.13. After post‐hoc analyses, there were no differences in referral rates between specialties. Common referral indications included patient history of mental illness, distress about having a genetic condition, and limited social support. Common barriers to referral were financial or insurance related, patient receptiveness, and the patient not perceiving a benefit. GCs felt that providing psychosocial support is within their scope of practice, but that MHPs are better equipped to manage long‐term needs and those related to a mental health condition. This study provides insight into how GCs decide when they can manage patient distress, circumstances that prompt a referral to MHPs, and barriers. Recognizing common referral indications and barriers may lead to better strategies for connecting patients with such services.