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. Sincerely, Angela M. Reiersen, MD, MPE Attending Physician – Child and Adolescent Psychiatry Washington University Department of Psychiatry