Assessing Mental Illness Referral Request Acceptance: A Nationwide E-Referral Data From Saudi Arabia

Abdullah A Alharbi,1 Nawfal A Aljerian,2– 4 Hani A Alghamdi,5 Meshary S Binhotan,4,6 Ali K Alsultan,2 Mohammed S Arafat,2 Abdulrahman Aldhabib,2 Ahmed I Aloqayli,2 Eid B Alwahbi,2 Ronnie D Horner7 1Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Kingdom o...

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Main Authors: Alharbi AA, Aljerian NA, Alghamdi HA, Binhotan MS, Alsultan AK, Arafat MS, Aldhabib A, Aloqayli AI, Alwahbi EB, Horner RD
Format: Article
Language:English
Published: Dove Medical Press 2025-02-01
Series:Journal of Multidisciplinary Healthcare
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Online Access:https://www.dovepress.com/assessing-mental-illness-referral-request-acceptance-a-nationwide-e-re-peer-reviewed-fulltext-article-JMDH
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Summary:Abdullah A Alharbi,1 Nawfal A Aljerian,2– 4 Hani A Alghamdi,5 Meshary S Binhotan,4,6 Ali K Alsultan,2 Mohammed S Arafat,2 Abdulrahman Aldhabib,2 Ahmed I Aloqayli,2 Eid B Alwahbi,2 Ronnie D Horner7 1Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Kingdom of Saudi Arabia; 2Medical Referrals Centre, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; 3Emergency Medical Services Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Science, Riyadh, Kingdom of Saudi Arabia; 4King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia; 5Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 6Emergency Medical Services Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia; 7Health Services Research and Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USACorrespondence: Meshary S Binhotan, Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 22490, Kingdom of Saudi Arabia, Email hotanm@ksau-hs.edu.saBackground and Objective: Mental disorders significantly impact quality of life and life expectancy, representing a leading cause of global disease burden. Healthcare systems worldwide face challenges in meeting mental health service demands, particularly due to specialist shortages and geographical barriers. Saudi Arabia has implemented an innovative nationwide electronic referral system (SMARC) as part of its digital health transformation strategy to enhance mental healthcare accessibility. This study examined SMARC’s effectiveness in facilitating mental health service access by analyzing patient transfer acceptance rates between healthcare facilities and identifying factors influencing these rates.Methods: This retrospective cross-sectional study analyzed 9722 mental health electronic referrals within SMARC from January 2020 to December 2021. Descriptive statistics characterized referral patterns, while bivariate and multivariable logistic regression analyses identified factors associated with referral acceptance, calculating adjusted odds ratios (aORs) and 95% confidence intervals.Results: The system achieved an overall acceptance rate of 82.5%, with different patterns across age groups and regions. Lower acceptance rates were observed for ages 15– 25 years (aOR = 0.84; 95% CI = 0.70– 0.99) and 46– 65 years (aOR = 0.83; 95% CI = 0.70– 0.99) compared to ages 26– 35 years. Life-saving referrals showed the highest acceptance (aOR = 2.60; 95% CI = 1.51– 4.48), while psychiatrist availability significantly influenced acceptance rates (aOR = 1.36; 95% CI = 1.17– 1.58). External referrals were half as likely to be accepted as internal ones (aOR = 0.51; 95% CI = 0.42– 0.64).Conclusion: SMARC demonstrates effectiveness in optimizing mental healthcare access through strategic matching of patient needs with available resources. The system’s selective acceptance patterns reflect its capability to prioritize care based on clinical urgency and resource availability. These findings provide valuable insights for policymakers to keep enhancing digital health infrastructure and mental healthcare delivery. The SMARC model offers a promising framework for implementing similar digital referral systems globally to improve mental healthcare coordination and accessibility.Keywords: mental health, psychiatry, referral systems, acceptance rates, health policy, Saudi Arabia, regional variation, Saudi Medical Referral Center
ISSN:1178-2390