The practice of psychiatry in general hospitals is increasing and some of the problems it raises have been widely discussed. Many administrative questions have received close attention (Bennett et al., 1956; Smith, 1961) and the advantage to psychiatric patients of having readily available medical, surgical and laboratory facilities has been clearly seen (Gillies, 1959). It has been shown, too, that patients with mental illness can be admitted to beds in medical wards and be treated there successfully (Brook and Stafford-Clark, 1961). On the other hand, much less attention has been given to the psychiatric requirements of the general hospital itself, and there is very little information about the use that physicians, surgeons and specialists are likely to make of a psychiatric service for their own in-patients. Studies of psychiatric morbidity among general ward patients (Mittelmann et al., 1945; Zwerling et al., 1955) are of great interest, but they tend to shed an artificial light on the problems of practical needs and probable demands. Shepherd, Davies and Culpan (1960) have provided the most useful report so far, on the incidence of psychiatric referrals by physicians and surgeons and the clinical conditions encountered. This was the result of a one-year work-study specially set up for the purpose of investigating these questions at a general hospital in London. However, there appears to have been no account of findings based on the routine work of a hospital where a psychiatric unit has been well established.
Delays in discharging elderly psychiatric in-patients