Table 2 Main themes and subthemes that emerged from provider focus group sessions

Main theme 1: Valuing the program because it is useful and benefits patients

Subtheme 1 (Psychiatric Residents):

Subtheme 1 (SPC Counselors):

Valuing the program because of their belief in the potential effectiveness: “An active referral that’s actually going to work”

Valuing the program because it allows them to be a safe “bridge” for patients

Main theme 2: Having a mutual desire to understand what happens from the ED to discharge to program follow-up

Subtheme 2 (Psychiatric Residents):

Subtheme 2 (SPC Counselors):

More than checking off a “checklist”: Desiring to know “what actually happens in the program” after a referral is made

Fixing the disconnect: Desiring to know “what’s happening on the side of the ED?”

Main theme 3: Uncertainty about which ED Patients would benefit from program services

Subtheme 3 (Psychiatric Residents):

Subtheme 3 (SPC Counselors):

Struggling to know which patients are “good fits” for the program

Wrestling with uneven realities: “first timers” and those with “many diagnoses” can potentially both benefit

Main them 4: Brainstorming to improve the referral process

Subtheme 4 (Psychiatric Residents):

Subtheme 4 (SPC Counselors):

Envisioning a more streamlined, efficient referral process

Having a wish list that includes getting key contextual and accurate referral information