The patient’s symptoms and functioning
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Patient is unable to function in daily life or unable to care for children. Substance abuse, trauma, psychosis, anxiety, depression, self-harm, suicidality, reckless or extreme behaviour, and eating disorders.
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Worsening of the patient’s mental illness. Patient’s motivation and cognitive capacity for treatment. Needs a specialist’s help for evaluation of medicine and diagnosis. Treatment options only in specialised health care. Patient is unable to care for children or attend work. Patient lacks or has an unsustainable network.
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Patient has deteriorating relationships. The patient’s symptoms (risk for suicide, psychosis). The patient’s daily functioning level.
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Contextual factors
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Geographical factors and infrastructure. Patient has a fragile or lacking network. Patient has a tired family. Limitations of the GP’s competence and confidence.
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Patient lacks housing. Patient’s upbringing. Patient’s network or family. If request is made during night or weekend. Patient living far away from SMHC, availability of transport. The GP cannot defuse the situation.
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The ‘adaptation process’
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Expected helpfulness
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