OBJECTIVE In the light of the increasing importance of the general practitioner as a gatekeeper within the German psychiatric health care system, his/her role needs to be evaluated. METHOD On the basis of the psychiatric documentation (DGPPN-BADO) of 4066 patients predictors for referral to inpatient psychiatric care by the general practitioner together with outpatient aftercare were analysed by means of logistic regression models. RESULTS 18.4% of the patients were referred by a general practitioner, mostly those with an affective disorder (Odds Ratio 4.0) or schizophrenia (OR 3.3), and residents of old people's or nursing homes (OR 3.5). In 49.9% of the patients, aftercare by a general practitioner was recommended - more frequently patients with addictive disease (OR 2.0), pensioners (OR = 1.7) and elderly patients (OR 1.03), more rarely patients with schizophrenia (OR 0.4) or affective disorders (OR 0.7). CONCLUSION In view of the relatively low referral rate, in-hospital quality management should focus on improving cooperation between psychiatric hospital and GP.