A Psychiatric Liaison Service in a General Hospital Referrals and Their Appropriateness

1994 ◽  
Vol 39 (5) ◽  
pp. 141-144 ◽  
Author(s):  
D.J. Hall
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Psychiatric Problem ◽  
Prior Training ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
Intensive Training ◽  
Psychiatric Referral ◽  
Self Harm

Referrals to a liaison psychiatry service, based in a District General Hospital, were studied over a six month period. 190 [89%] of the 214 referrals were for assessment following an episode of deliberate self harm. An excess of these referrals were male [57%] and a large proportion particularly of the males [36%] were diagnosed as having a significant alcohol problem. Many were felt to have no significant psychiatric problem [31%], and a large proportion were discharged with no psychiatric follow-up [28%]. Patterns of diagnosis and disposal differed between the sexes. Referring junior medical staff when asked to give their opinions on the likely management and overall need for psychiatric referral of patients were found to reach reasonable agreement with the assessing psychiatrist, even without prior training, and to be more cautious in their assessment. In many centres the trend is towards selective referral of deliberate self harm patients, and this appears a safe and appropriate development which can be achieved without intensive training or major alterations to working patterns, and which will result in modest but important reductions in inappropriate referrals.

scholarly journals Psychiatric and personality disorders in deliberate self-harm patients

2001 ◽  
Vol 178 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Camilla Haw ◽  
Keith Hawton ◽  
Kelly Houston ◽  
Ellen Townsend
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
General Hospital ◽  
Representative Sample ◽  
Deliberate Self Harm ◽  
Common Diagnosis ◽  
Icd 10 ◽  
Self Harm

BackgroundPrevious UK studies have reported much lower rates of psychiatric and personality disorder in those who attempt suicide than in those who die by suicide.AimsTo determine the nature and prevalence of psychiatric and personality disorders in deliberate self-harm (DSH) patients.MethodA representative sample of 150 DSH patients who presented to a general hospital were assessed using a structured clinical interview and a standardised instrument. Follow-up interviews were completed for 118 patients approximately 12–16 months later.ResultsICD–10 psychiatric disorders were diagnosed in 138 patients (92.0%), with comorbidity of psychiatric disorders in 46.7%. The most common diagnosis was affective disorder (72.0%). Personality disorder was identified in 45.9% of patients interviewed at follow-up. Comorbidity of psychiatric and personality disorder was present in 44.1%.ConclusionsPsychiatric and personality disorders, and their comorbidity, are common in DSH patients. This has important implications for assessment and management.

scholarly journals Liaison psychiatry in detection and management of mental illness

1996 ◽  
Vol 20 (8) ◽  
pp. 466-469
Author(s):  
Margaret Semple ◽  
David Brown ◽  
Elizabeth Irvine
Keyword(s):  
Mental Illness ◽  
Mental Disorder ◽  
Alcohol Misuse ◽  
Psychiatric Service ◽  
Psychiatric Ward ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
General Psychiatry ◽  
Self Harm

Of 299 referrals to the Dundee general psychiatry liaison service over a six month period, deliberate self-harm (DSH) was the reason in 83%. An overdose was used in 94%, and alcohol misuse occurred in 56% of DSH episodes. Fifty-two per cent of referrals were followed up by the general psychiatry service; 31% of these were admitted directly to a psychiatric ward, 10% on a compulsory basis. At follow-up, 23% remained in contact with the Dundee psychiatric service. Twenty-three per cent of all patients referred to the Area Alcohol Service (AAS) were in contact with it six months later. Clearly, liaison psychiatry has a role in detection and management of significant mental disorder.

scholarly journals Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital

2003 ◽  
Vol 182 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Keith Hawton ◽  
Daniel Zahl ◽  
Rosamund Weatherall
Keyword(s):  
General Hospital ◽  
Age Groups ◽  
First Year ◽  
Prevention Strategies ◽  
Deliberate Self Harm ◽  
Long Term Follow Up ◽  
Self Harm ◽  
Annual Risk

BackgroundDeliberate self-harm (DSH) is the strongest risk factor for future suicide. Up-to-date information on the extent of risk is lacking.AimsTo investigate the risk of suicide after DSH during a long follow-up period.MethodA mortality follow-up study to 2000 was conducted on 11583 patients who presented to hospital after DSH between 1978 and 1997. Data were obtained from a general hospital DSH register in Oxford and the Office for National Statistics, and from equivalent mortality registers in Scotland and Northern Ireland.ResultsThree hundred patients had died by suicide or probable suicide. The risk in the first year of follow-up was 0.7% (95% CI 0.6–0.9%), which was 66 (95% CI 52–82) times the annual risk of suicide in the general population. The risk after 5 years was 1.7%, at 10 years 2.4% and at 15 years 3.0%. The risk was far higher in men than in women (hazard ratio 2.8, 95% CI 2.2–3.6). In both genders it increased markedly with age at initial presentation.ConclusionsFollowing DSH there is a significant and persistent risk of suicide, which varies markedly between genders and age groups. Reduction in the risk of suicide following DSH must be a key element in national suicide prevention strategies.

scholarly journals Deliberate self-harm: service development in Kettering

1995 ◽  
Vol 19 (8) ◽  
pp. 475-477 ◽  
Author(s):  
Catherine Gordon ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Service Provision ◽  
Public Health Problem ◽  
District General Hospital ◽  
Service Development ◽  
Paracetamol Poisoning ◽  
Deliberate Self Harm ◽  
Threefold Increase ◽  
Self Harm ◽  
Recent Trends

Services for deliberate self-harm patients in the general hospital are unsatisfactory in many respects. A survey of activity and quality in a district general hospital confirmed recent trends observed elsewhere and highlights areas in which service provision can be improved.High rates of deliberate self-harm (DSH) are a public health problem. A study in Oxford showed rising rates among young women during the late 1980s, and a threefold increase in the proportion due to paracetamol poisoning between 1976 and 1990 (Hawton & Fagg, 1992). A multicentre European study found a trend of increasing peak age, a declining female to male ratio, and unexplained differences between regions (Platt, 1992). In the year following DSH, 9% repeat (Hawton & Fagg, 1992); and suicide rates reach 1.1 to 1.3% of patients in the three years following an episode of DSH (Owens et al. 1991).

Assessment and Aftercare for Deliberate Self-Harm Patients Provided by a General Hospital Psychiatric Service

Crisis ◽  
2003 ◽  
Vol 24 (4) ◽  
pp. 145-150 ◽  
Author(s):  
Camilla Haw ◽  
Keith Hawton ◽  
Linda Whitehead ◽  
Kelly Houston ◽  
Ellen Townsend
Keyword(s):  
Open Access ◽  
General Hospital ◽  
Psychiatric Service ◽  
Deliberate Self Harm ◽  
Patients Satisfaction ◽  
Assessment And Treatment ◽  
Self Harm

Summary: We report on a sample of 135 deliberate self-harm (DSH) patients who were assessed by a general hospital DSH service, and on those who were offered aftercare by, or telephone open access to, the service. Patients' satisfaction with assessment and treatment, and their outcome were investigated at follow-up 12-20 months later. Four-fifths of patients reported the assessment following DSH to have been helpful and the assessor sympathetic. Thirty-three (24%) of the 135 patients assessed were offered treatment by the DSH service but 13 declined or failed to attend. Of the 20 who engaged in treatment, 17 (94%) were satisfied with their care. Open access to the DSH service by telephone was offered to 53 (39%) patients, nine (22%) of whom reported at follow-up that they had used this facility. A specialist DSH service can effectively assess and treat patients following DSH. It is important that the service is accessible and acceptable to patients.

The Impact of a Liaison Psychiatry Service on Patterns of Referral in a General Hospital

1987 ◽  
Vol 150 (1) ◽  
pp. 83-87 ◽  
Author(s):  
A. Brown ◽  
A. F. Cooper
Keyword(s):  
Retrospective Study ◽  
General Hospital ◽  
Referral Rate ◽  
Hospital Inpatient ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Inpatient Population ◽  
The Impact

A retrospective study of psychiatric referrals from a general hospital inpatient population was carried out for three separate years, 1973, 1976 and 1979. Reorganisation of the liaison service to the responsibility of one consultant team was associated with changes in referral rate and disposal. In particular, there was a significant increase in the referral rate of patients from medical and surgical wards who were not involved in acts of deliberate self-harm.

scholarly journals Training in liaison psychiatry

1993 ◽  
Vol 17 (2) ◽  
pp. 95-96 ◽  
Author(s):  
A. O. House ◽  
F. Creed
Keyword(s):  
General Hospital ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
Training Scheme ◽  
Self Harm

It is generally agreed that training in liaison psychiatry should be available at SHO/registrar grade, but the College's guidelines are not specific about what it might entail. As a result it is difficult for approval visitors to decide whether a particular post on a rotational training scheme truly provides liaison experience. At times so-called “liaison experience” amounts to no more than participation in a duty-rota for visiting a general hospital to undertake the assessment of cases of deliberate self-harm.

Sign in / Sign up

Export Citation Format

Share Document