scholarly journals A standard liaison psychiatry service structure?

2003 ◽  
Vol 27 (12) ◽  
pp. 457-460 ◽  
Author(s):  
Rachel Ruddy ◽  
Allan House
Keyword(s):  
General Hospital ◽  
Clinical Psychologists ◽  
Psychiatric Services ◽  
Multidisciplinary Teams ◽  
Clinical Implications ◽  
Minimum Standard ◽  
Liaison Psychiatry ◽  
Rational Planning ◽  
Health Authorities

Aims and Method We surveyed all psychiatric services in the six northeast strategic health authorities to determine how the provision of liaison psychiatry services related to College recommendations and the size of the general hospital trusts served. Results Thirty-six (100%) services provided usable data, 8% of general hospital trusts had no liaison psychiatry service, 41% of teams were not multidisciplinary with their only staff being nurses, only 38% of services had dedicated consultant psychiatry time and only a quarter met the recommended minimum standard of 0.5 whole-time equivalents. No teams contained clinical psychologists. Disorder-specific out-patient clinic provision was idiosyncratic. Clinical Implications There is a lack of rational planning of liaison psychiatry services and as a result, many services are not needs-based and do not comply with College recommendations. One indication of this is the lack of multidisciplinary teams.

scholarly journals A standard liaison psychiatry service structure?

2003 ◽  
Vol 27 (12) ◽  
pp. 457-460 ◽  
Author(s):  
Rachel Ruddy ◽  
Allan House
Keyword(s):  
General Hospital ◽  
Clinical Psychologists ◽  
Psychiatric Services ◽  
Multidisciplinary Teams ◽  
Clinical Implications ◽  
Minimum Standard ◽  
Liaison Psychiatry ◽  
Rational Planning ◽  
Health Authorities

Aims and MethodWe surveyed all psychiatric services in the six northeast strategic health authorities to determine how the provision of liaison psychiatry services related to College recommendations and the size of the general hospital trusts served.ResultsThirty-six (100%) services provided usable data, 8% of general hospital trusts had no liaison psychiatry service, 41% of teams were not multidisciplinary with their only staff being nurses, only 38% of services had dedicated consultant psychiatry time and only a quarter met the recommended minimum standard of 0.5 whole-time equivalents. No teams contained clinical psychologists. Disorder-specific out-patient clinic provision was idiosyncratic.Clinical ImplicationsThere is a lack of rational planning of liaison psychiatry services and as a result, many services are not needs-based and do not comply with College recommendations. One indication of this is the lack of multidisciplinary teams.

scholarly journals Liaison psychiatry for older adults in the general hospital: service activity, development and outcomes

2018 ◽  
Vol 42 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Fedza Mujic ◽  
Ruth Cairns ◽  
Vivienne Mak ◽  
Clare Squire ◽  
Andrew Wells ◽  
...  
Keyword(s):  
Older Adults ◽  
General Hospital ◽  
Outcome Measures ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Case Load ◽  
Service Activity ◽  
Training Activities ◽  
Load Characteristics ◽  
And Training

Aims and methodThis study used data collected to describe the activity, case-load characteristics and outcome measures for all patients seen during a 6-year period.ResultsThe service reviewed 2153 patients over 6 years with referral rates and case-load characteristics comparable to those described in a previous study period. The team saw 82% of patients on the day they were referred. Data and outcome measures collected showed significant complexity in the cases seen and statistically significant improvement in Health of the Nation Outcome Scales (HoNOS) scores following service input.Clinical implicationsThe outcome measures used were limited, but the study supports the need for specialist liaison psychiatry for older adults (LPOA) services in the general hospital. The Framework of Outcome Measures – Liaison Psychiatry has now been introduced, but it remains unclear how valid this is in LPOA. It is of note that cost-effectiveness secondary to service input and training activities are not adequately monitored.Declaration of interestNone.

scholarly journals ‘We've got another one for you!’ Liaison psychiatry's experience of stigma towards patients with mental illness and mental health professionals

2012 ◽  
Vol 36 (12) ◽  
pp. 450-454 ◽  
Author(s):  
Jim Bolton
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Patient Care ◽  
General Hospital ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Clinical Communication ◽  
The Impact

Aims and methodTo assess stigmatising attitudes towards mental illness and psychiatric professionals experienced by UK liaison psychiatry staff. A questionnaire asked about the impact of these events on patient care and for suggestions for tackling stigma in the general hospital.ResultsOut of 72 multidisciplinary respondents, over three-quarters had experienced stigmatising attitudes towards mental illness by general hospital colleagues at least monthly. Two-thirds reported instances where stigmatisation had an adverse impact on patient care, and over a quarter reported stigmatising attitudes towards mental health professionals. Suggestions for combating stigma included educational initiatives, clear clinical communication, and the provision of high-quality liaison services.Clinical implicationsLiaison psychiatry is well placed to both recognise and combat stigma in the general hospital. This can help to ensure that patient care is comprehensive, safe and respectful.

scholarly journals Comparison of liaison psychiatry service models for older patients

2004 ◽  
Vol 28 (5) ◽  
pp. 171-173 ◽  
Author(s):  
Fedza Mujic ◽  
Charlotte Hanlon ◽  
Danny Sullivan ◽  
Gina Waters ◽  
Martin Prince
Keyword(s):  
Older Patients ◽  
Waiting Times ◽  
Psychiatric Services ◽  
Case Mix ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Speed Of Response ◽  
Service Models ◽  
Before And After ◽  
Consultation Model

Aims and MethodAt a London teaching hospital, the existing off-site consultation model psychiatric liaison service for older people was replaced with an on-site liaison model service in December 2000. Several indicators of the functioning of the service were audited using identical methods before and after this change.ResultsThe case-load increased by 50%, but the liaison psychiatrists were more satisfied with the appropriateness of referrals. The case mix did not change. The new service achieved target waiting times more consistently, particularly for urgent referrals. Referring teams were more satisfied with the speed of response, while the new service maintained the salience and clarity of advice.Clinical ImplicationsFindings are on the whole favourable, and support the wider introduction of specialist old-age liaison psychiatric services.

Consultation-liaison psychiatry hits a midlife crisis

2002 ◽  
Vol 10 (3) ◽  
pp. 229-231
Author(s):  
Sandy Macleod
Keyword(s):  
General Hospital ◽  
Future Development ◽  
Psychiatric Services ◽  
New Work ◽  
Work Skills ◽  
Job Descriptions ◽  
Liaison Psychiatry ◽  
Midlife Crisis ◽  
Hospital Patients ◽  
Consultation Liaison Psychiatry

Objective: To illustrate the crisis affecting consultation-liaison psychiatry and its practitioners. Conclusions: There are several options that may be taken, or have already been taken, to secure a future for this psychiatric subspecialty. The need is apparent, and clinicians are willing, but funders are reluctant. The College's response has been critically important, but psychiatrists also need to develop new work skills and innovative job descriptions to ensure the continuation and future development of psychiatric services to general hospital patients.

scholarly journals Twenty-eight years of liaison psychiatry at a general hospital

1998 ◽  
Vol 22 (12) ◽  
pp. 754-758 ◽  
Author(s):  
A. J. Carson ◽  
H. Dawson ◽  
D. Marshall ◽  
K. Stafford
Keyword(s):  
Patient Outcome ◽  
General Hospital ◽  
Referral Rate ◽  
Physician Satisfaction ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Referral Rates ◽  
A Priority ◽  
Future Direction

Aims and methodA questionnaire was used to measure physician satisfaction with the unit and comparison of referral numbers and diagnoses with 1967, when the unit was new, and in 1985 when it was re-audited.ResultsDespite physicians' satisfaction with the service, the referral rate remains unchanged.Clinical implicationsLiaison psychiatry should not concern itself with trying to increase referral rates. Research into patient outcome should be a priority and guide its future direction.

scholarly journals Thirty years of in-patient consultation-liaison psychiatry at Guy's

1995 ◽  
Vol 19 (10) ◽  
pp. 631-634 ◽  
Author(s):  
Ben Lucas ◽  
Harry Doyle
Keyword(s):  
General Hospital ◽  
Patient Population ◽  
Substance Misuse ◽  
General Medicine ◽  
Psychiatric Services ◽  
Liaison Psychiatry ◽  
Planning Decisions ◽  
Unmet Demand ◽  
Consultation Liaison Psychiatry ◽  
Patient Consultation

In order to inform planning decisions, we aim to show how an in-patient consultation-liaison service has changed in 30 years. A year's referral of 175 inpatients was compared with surveys carried out in the same hospital 20 and 30 years previously. Neurosciences continue to refer the greatest percentage of its patients while general medicine produces the greatest demands on the service. There has been a large increase in substance misuse referrals, although other diagnostic groups have similar referral rates. Liaison service planners should be aware of the unmet demand for psychiatric services of the general hospital in-patient population.

scholarly journals Diagnostic Agreement between Physicians and a Consultation–Liaison Psychiatry Team at a General Hospital: An Exploratory Study across 20 Years of Referrals

2021 ◽  
Vol 18 (2) ◽  
pp. 749
Author(s):  
Mattia Marchi ◽  
Federica Maria Magarini ◽  
Giorgio Mattei ◽  
Luca Pingani ◽  
Maria Moscara ◽  
...  
Keyword(s):  
General Hospital ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Clinical Signs ◽  
Kappa Statistics ◽  
Comorbid Depression ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry ◽  
Psychiatric Conditions ◽  
Diagnostic Concordance

Consultation–liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000–2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.

Acute Psychiatric Services in the General Hospital: II. Current Status of Emergency Psychiatric Services

1967 ◽  
Vol 124 (4S) ◽  
pp. 37-45 ◽  
Author(s):  
HOWARD T. BLANE ◽  
JAMES J. MULLER ◽  
MORRIS E. CHAFETZ
Keyword(s):  
General Hospital ◽  
Psychiatric Services ◽  
Current Status

scholarly journals A new opportunity: three tales of training in liaison psychiatry of old age

2002 ◽  
Vol 26 (11) ◽  
pp. 433-435 ◽  
Author(s):  
John Holmes ◽  
Jon Millard ◽  
Susie Waddingham
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Specialist Training ◽  
Liaison Psychiatry ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Hospital Wards ◽  
And Training

Liaison psychiatry has emerged as a sub-speciality within general adult psychiatry, with specific experience and training being required to develop the skills and knowledge to address comorbid physical and psychiatric symptoms and illness (House & Creed, 1993; Lloyd, 2001). Older people often present with significant physical and psychiatric comorbidity (Ames et al, 1994; Holmes & House, 2000) and most old age psychiatry services receive one-quarter to one-third of referrals from general hospital wards (Anderson & Philpott, 1991). Despite this, there are no specific requirements for training in liaison psychiatry for old age psychiatrists at any level. The experience gained in assessing and treating general hospital referrals during basic and higher specialist training is felt to be adequate (Royal College of Psychiatrists, 1998).

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