did 15% of 687 psychiatry referrals get a brief phone consult instead of an assessment?
“Among the 687 referrals over seven months, only a small minority, 15%, were handled with this brief phone consultation.”
a host, a psychiatrist said on The Carlat Psychiatry Podcast, 2026-09-28, at 13:46. hear it in context → the speaker cited: Giuseppe Guiana and colleagues, Community Mental Health Journal.
the episode: ADHD Undone: The Corporate Practice of Medicine (at 13:46). we link the show's own page; we do not re-host audio.
first, the part that holds
the study exists and the frame is right: a 2026 Community Mental Health Journal quality-improvement paper reports that 687 outpatient psychiatry referrals were reviewed between November 2022 and May 2023, which is seven months, and that psychiatrist-led phone consultation was part of the new triage model. the first author's surname is spelled Guaiana in the record.
what we found when we went and looked
we found the paper on PubMed (PMID 42536132; Community Ment Health J, published online 2026-07-31, doi 10.1007/s10597-026-01702-w). its abstract confirms 687 referrals over November 2022 to May 2023. it reports 495 (72%) accepted for psychiatric assessment and 192 (28%) redirected, and says phone consultations rose from about one a month to 12-15 a month, each taking about 10 minutes against a 90-minute standard assessment. the abstract never gives a share of referrals handled by phone, and the full text is paywalled, so we could not find "15%" anywhere we were able to read. by our own arithmetic, 12-15 a month for seven months comes to roughly 84-105 calls, or about 12-15% of 687, so the figure is plausible as a ceiling. it is not something the record we read states.
assertion by assertion
| assertion | verdict | what the record says |
|---|---|---|
| the study is in Community Mental Health Journal, by a psychiatrist named Guaiana and colleagues | confirmed | PubMed lists the paper by three authors, first author surname Guaiana: "Reducing Outpatient Psychiatry Wait Times Through Structured Triage and Telephone Consultation: A Quality Improvement Initiative," Community Ment Health J. 2026 Jul 31, doi 10.1007/s10597-026-01702-w. the claim as heard spells the surname differently, which looks like a transcription variant. [1][2] |
| 687 referrals over seven months | confirmed | the abstract says: "Between November 2022 and May 2023, 687 outpatient psychiatry referrals were reviewed." November through May inclusive is seven months. the paper says the referrals were "reviewed", not "received", which makes no practical difference here. [1][2] |
| 15% of the referrals were handled by brief phone consultation | unverifiable | the abstract gives no count or percentage of referrals handled by phone. it gives only a monthly rate after implementation (12-15 a month, up from about 1). our own estimate from that rate, 84-105 over seven months or 12-15% of 687, puts 15% at the top of the range. that estimate assumes the full rate held for all seven months, and the paper describes a ramp-up from one a month. the paywalled full text may report an exact figure, but we could not read it. [1][2] |
| context: how the 687 referrals were split overall | confirmed | "Of these, 495 (72%) were accepted for psychiatric assessment and 192 (28%) were redirected." phone consultation would be one route inside the 28% redirected. the abstract does not break the 192 down by route, so the 28% figure must not be read as the phone share. [1][2] |
| context: the outcome the paper reports | confirmed | phone consultations averaged about 10 minutes against 90-minute standard assessments. average outpatient wait fell from about 10 months before implementation to about 6 weeks afterwards. this was a single-site before-and-after quality-improvement study with no control group. [1][2] |
both directions
for the speaker: the paper, journal, referral count and seven-month window all match the record. the 12-15-a-month phone rate in the abstract, multiplied over seven months, gives roughly 12-15% of 687 referrals, which agrees with the speaker's 15% and with calling phone consultation "a small minority". the speaker's point that most referrals still went to full assessment is backed by the 72% accepted figure.
against: no record we could read states 15%. the abstract reports a monthly rate, not a share of the 687. that rate rose from about one a month, so a seven-month total is probably below the 84-105 implied by the steady-state rate, which would make the real share under 15%, possibly well under. it is also easy to mix up "15%" with the "12-15 per month" figure in the abstract. separately, 28% of referrals were redirected in total, so phone consultation was not the only way referrals avoided a full assessment.
what this cannot say
we read only the PubMed abstract and the publisher's abstract page. the full article is paywalled and may contain a table that confirms or corrects the 15% figure. our 12-15% estimate is back-of-envelope and assumes a steady rate the paper does not claim. this is a single-site quality-improvement report with no comparison group, so even the exact numbers describe one service over seven months. the speaker may have had access to the full text.
sources, each one fetched and read
- Guaiana G, Coffey L, Haykus E. Reducing Outpatient Psychiatry Wait Times Through Structured Triage and Telephone Consultation: A Quality Improvement Initiative. Community Ment Health J. 2026 Jul 31. doi:10.1007/s10597-026-01702-w. PMID 42536132 (PubMed abstract record) What we read there: "Between November 2022 and May 2023, 687 outpatient psychiatry referrals were reviewed. Of these, 495 (72%) were accepted for psychiatric assessment and 192 (28%) were redirected." phone consultations "increased from approximately one per month to 12-15 per month" and "averaged approximately 10 min" against 90-minute assessments; wait times fell from about 10 months to about 6 weeks. Fetched 2026-10-12 (HTTP 203). https://pubmed.ncbi.nlm.nih.gov/42536132/
- Springer, Community Mental Health Journal, article page for doi:10.1007/s10597-026-01702-w (abstract only; full text paywalled) What we read there: same abstract: study period November 2022 to May 2023, 687 referrals, 72% accepted / 28% redirected, 12-15 phone consultations a month after implementation. no count or percentage of referrals handled by phone, and no breakdown of the 192 redirected referrals. Fetched 2026-10-12 (HTTP 200). https://link.springer.com/article/10.1007/s10597-026-01702-w?error=cookies_not_supported&code=2eecd838-deae-46ce-a81d-38c58c8373c2
speakers are described by role, not named. one sentence is quoted under fair use, with attribution and a link to the original at the timestamp; we do not re-host audio or video. nothing on this page is a reason to start, stop or change a medication. if you have the file behind anything marked unverifiable, the research board is where people can answer. adam