The patient

Many patients have had no experience of mental health care but a long history of medical treatment and a somatic concept of illness. The referral is rarely initiated by the patient, who may be beset by fantasies and fears. The psychiatrist needs to assess the patient's (and the family's) expectations and fears (e.g. being stigmatized as a psychiatric case or being abandoned by the physician) and obtain his or her agreement to assessment and treatment. Preparation for the psychiatric consultation by the referring physician should be mandatory. A personal introduction by the physician or a joint initial consultation can improve the patient's motivation and inform the physician.

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