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Factors | Less suited towards referral | More suited towards referral |
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Patient and family factors | Belief in stigmatization of psychiatric care and that it may not be helpful | Acceptance that psychiatric referral can be helpful and is not stigmatizing |
Belief in external locus of control of symptoms | Belief in internal locus of control of symptoms |
Fair to good insight and awareness of psychosocial stressors | Poor to fair insight and awareness of psychosocial stressors |
More emotionally supportive and more physically present family and or friends | Less emotionally supportive and less physically present family and or friends |
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Provider factors | | |
Neurologist (referring physician) factors | Comfortable and/or has sufficient time and energy to manage psychiatric comorbidities | Less comfortable and has insufficient time to manage psychiatric comorbidities |
Psychiatrist (receiving physician) factors | Not as interested in care of patients with neurological disorders or not believing that psychiatric/psychological interventions may be helpful | Comfortable with and has predilection to manage affectively challenging patients |
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System factors | Lack of availability of psychiatrists and psychologists locally | Availability of psychiatrists and psychologists as well as opportunities to build “shared appointments” with neurologists |
Inability of neurologists and psychiatrists to dedicate sufficient time to care coordination for patients with NES | Ability of neurologists and psychiatrists to communicate effectively and have regular meetings and or open channels of communication regarding care coordination for patients with NES |
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