Refer all people with suspected bipolar disorder to a specialist mental health service to confirm the diagnosis, treat the acute episode, and establish a care plan NICE CKS.
Refer urgently if the person presents with mania, severe depression, or if they are a danger to themselves or others NICE CKS.
Refer for a specialist assessment if there is a poor or partial response to treatment, significant decline in functioning, intolerable or medically important side effects from medication, suspected comorbid alcohol or drug misuse, or if the person is considering stopping medication after stability NICE CKS.
Refer immediately to a specialist if the person exhibits mania or severe depression with immediate risk of harm to themselves or others NICE CKS.
In children and adolescents, refer urgently if there are signs of mania, severe depression, or risk of harm, and manage according to existing care plans or seek specialist advice NICE CKS.
In adults, refer for a specialist assessment if there is suspicion of mania or severe depression, or if the person is a danger to themselves or others NICE CKS.