# When should a counsellor or psychologist refer a client for psychiatric or medical review?

URL: https://tymirahealth.com/resources/faqs/when-should-a-counsellor-or-psychologist-refer-a-client-for-psychiatric-or-medical-review
For: Clinicians | Mental health care | Reviewed by Independent clinical reviewer, Registered mental health clinician, Kenya | Last reviewed 8 November 2026

**Answer:** Kenya's 2024 clinical guidelines describe comprehensive assessment, including suicide risk and physical examination, and integrated care across medical, psychological and social interventions. WHO mhGAP advises referral to specialists for complex or severe presentations. Common triggers include imminent suicide risk, psychosis, severe or worsening symptoms, possible need for medication, substance withdrawal, and suspected physical causes. Counsellors and psychologists do not prescribe, so agree referral pathways with psychiatrists, medical officers or psychiatric clinical officers in advance.

Sources: Ministry of Health, Kenya: https://mental.health.go.ke/download/national-clinical-guidelines-for-management-of-common-mental-disorders/ - World Health Organization: https://cdn.who.int/media/docs/default-source/brain-health/mhgap-training-manuals/sui_module.pdf?sfvrsn=bb7a26ed_5 - Kenya Law: https://new.kenyalaw.org/akn/ke/act/1989/10/eng@2023-12-11

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