First Contact Welcome Letter - Division of Child and Adolescent

TO: Referring Providers Interested in Referring to the Washington University Department of
Psychiatry First Contact Assessment Service
Welcome to the First Contact Assessment Service!
The First Contact Assessment Service is a specialized second opinion clinic that evaluates individuals
who are suspected of having prodromal schizophrenia or other forms of psychosis. Signs of prodromal
schizophrenia may include deterioration of functioning and subtle psychotic-like symptoms without
clear evidence of active psychosis. This service can also evaluate individuals with any type of psychiatric
symptoms plus a known genetic risk for psychosis (i.e., genetic disorders that are known to increase the
risk for psychosis or a first degree relative with schizophrenia). If there are already clear and active
psychotic symptoms (such as clear and prominent hallucinations and delusions), and particularly if
there are any immediate safety concerns, then referral of the patient to an emergency room for
potential inpatient psychiatric admission would be more appropriate. Individuals referred for
evaluation by the First Contact Assessment Service must first go through a screening process. We prefer
to obtain screening information from the referring provider, and we may also need to speak to a parent
or guardian to obtain additional information about the referred child before deciding whether to
evaluate a case. Our evaluation team will review the responses to the screening questions and will
decide whether a First Contact Assessment seems appropriate. The full evaluation may require up to
four visits to our clinic and includes detailed structured diagnostic interviews completed by the child
and/or parent/guardian, questionnaires regarding a variety of relevant behaviors and developmental
experiences completed by the child, parent/guardian and/or teacher, a neurological soft signs
examination, and when appropriate, a neuropsychological assessment. The First Contact Assessment
Service generally does not take over patient care, but provides an evaluation report with
recommendations to the treating mental health provider. We ask that you provide the name and
contact information for the mental health treatment provider before the assessment is scheduled.
Usually this is a psychiatrist, but in some cases it may be a pediatrician or neurologist who is comfortable
prescribing psychiatric medications if this is needed. We can also send copies of our reports to
additional treating providers (i.e., primary care physician or psychotherapist) if appropriate.
Please do not hesitate to call our clinic with any questions. Our phone number is 314-286-1700.
Angela M. Reiersen, MD, MPE
Attending Physician – Child and Adolescent Psychiatry
Washington University Department of Psychiatry