ABSTRACT

When patients suffering with pain are referred to a mental health professional, there are a number of specific questions that need to be addressed related to the purpose of the assessment. A primary care physician may simply conduct a mental status assessment to assist in routine treatment planning and to identify any significant emotional problems that need to be addressed. Referral questions might be initiated by a governmental agency related to disability determination or vocational issues. A specific referral question from a third-party payer may focus on the issue of malingering. The referral question might be related to decisions that will influence initiation of a particular treatment. For example, a surgeon might refer a patient for assessment in order to determine whether the patient is a good candidate for a particular surgery or neuroaugmentation procedure (i.e., implantation of a spinal cord stimulator or implantable drug delivery system). Alternatively, a physician may seek advice concerning whether there are any contraindications for initiating a course of chronic opioid therapy. Another referral question may concern the appropriateness of a patient for enrollment in a rehabilitation program that involves self-management.