ABSTRACT Introduction The project is a study of referral practices and intake teams assessment of referrals to child and adolescent psychiatry outpatient clinics in Østfold Hospital Trust. The project group evaluated whether the clinics ensure equal opportunities for children and young people with mental disorders. We seek answers to whether the outcome of the assessment done by the outpatient clinics depends on the referrer, previous measures in municipal services and the quality of the referrals. We also assessed if the assessment practices are in accordance with guidelines and legislation. Methods A document analysis of 120 patients referred to five child and adolescent psychiatry outpatient clinics in Østfold was done. 24 cases were reviewed per clinic, 12 accepted and 12 declined. In each case the referral, the assessment notes and the feedback notes to both referrer and patient were assessed. Our data were then analyzed and categorized and compared to guidelines and legislation. Results We ve found that the family doctors as a group of referrers has the lowest rejection rate, but also poorer referral quality based on our parameters. A previous measure in municipal services was the strongest indicator of assessment outcome. In about 50% of the cases the assessment was in accordance with guidelines. We found consistently different practices in the assessment work between the five outpatient clinics. Conclusion The outcome of a referral depends to a certain extent on the referrer. Our data show that referrals of better quality are not more likely to be given acceptance than those of poorer quality, but previous attempt in municipal services was a stronger indicator. Low correlation with guidelines and consistently different practices within the clinics suggest that equal rights to prioritized health care were not maintained.