Factors That Influence MSW Students’ Referral Decisions for Depression: A Factorial Survey

Purpose Depression is one of the most commonly treated conditions in mental health practice. However, outcomes have been poor and social workers face a host of treatment-related dilemmas. Method This study used factorial survey methodology to disentangle the effects of client, practice, and respondent characteristics on master's in social work (MSW) students’ antidepressant referral decisions. A total of 426 ( n = 426) MSW students each judged three unique vignette scenarios yielding 1,266 ( n = 1,266) judgments analyzed using multilevel model analyses. Results Findings suggest that the decision to refer was most influenced by previous response to antidepressant treatment, symptom profiles with suicidal ideations and anxiety, and recurrent episodes of depression. To a lesser degree, respondents’ personal use of psychotropic medications and beliefs about physician prescribing patterns also influenced antidepressant referral decisions. Discussion This study illuminates the complex effects of clinical and non-clinical factors on MSW students’ antidepressant referral decisions.