scholarly journals Liaison psychiatry or psychological medicine?

2003 ◽  
Vol 183 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Geoffrey G. Lloyd ◽  
Richard A. Mayou
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Liaison Psychiatry ◽  
Hospital Patients ◽  
Psychological Medicine ◽  
Substantial Progress ◽  
Delivery Of Medical Care ◽  
The Uk ◽  
Psychiatric Profession ◽  
Behavioural Aspects

Liaison psychiatry has been recognised in many countries as a special interest or sub-speciality of psychiatry concerned with the management of general hospital patients with psychological problems. However, despite increasing awareness of the emotional and behavioural aspects of illness, it has yet to achieve substantial influence within psychiatry and, more importantly, has had only modest effects on the delivery of medical care by physicians and other specialists. Recognition of its potential by planners and commissioners has been disappointing. Regrettably, in the UK and elsewhere, recent changes in the organisation of health care could hinder its development. This paper argues that in order to make substantial progress there is a compelling need to solve a fundamental obstacle – the separation between psychiatric and general medical care. This requires:(a) convincing the psychiatric profession that consultation-liaison is a distinct sub-speciality;(b) continuing efforts by liaison psychiatrists to define their special expertise and to demonstrate that their services are effective and acceptable to medical colleagues and to patients;(c) persuading those who organise health care that liaison psychiatry services need to be provided and administered as an integral component of comprehensive medical care.

Paradoxes of Practice Guidelines, Professional Expertise, and Patient Centeredness: The Medical Care Triangle

2018 ◽  
Vol 76 (4) ◽  
pp. 359-385 ◽  
Author(s):  
L. Michele Issel
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Practice Guidelines ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Professional Expertise ◽  
Work Processes ◽  
Patient Centeredness ◽  
Medical Practitioners ◽  
Delivery Of Medical Care

The coexistence of institutionalized evidence-based practice guidelines, professional expertise of medical practitioners, and the patient centeredness approach form a triangle. Each component of this Medical Care Triangle has characteristics that create paradoxes for health care professionals and their patients. The value of a paradox lies in uncovering and utilizing the contradiction to better understand the underlying organizational phenomenon. Method: Following Poole and van de Ven’s (1989) suggested approaches to resolving paradoxes, each paradox of the Medical Care Triangle is defined and analyzed. Results: A total of 10 paradoxes related to practice guidelines, professional expertise, and patient centeredness are revealed. The resolution of each paradox yields insights specific to structuring health care organizations in ways that support the delivery of medical care. Implications: The results renew an emphasis on the centrality of practitioners’ work processes to health care organizations; this has potential benefits for organizations, clinicians/employees, and patients.

To the question of the role of consultation liaison psychiatry in diagnostics of psychosomatic disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S316
Author(s):  
V. Lebedeva ◽  
O. Pavlova ◽  
E. Yurovskaya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
General Medicine ◽  
Gastrointestinal Diseases ◽  
Psychosomatic Disorders ◽  
Liaison Psychiatry ◽  
Psychosomatic Disorder ◽  
Primary Health ◽  
Consultation Liaison Psychiatry

BackgroundRelevance of consultation liaison psychiatry is conditioned by trend of steady rise of psychosomatic disorders and insufficient development of supplied forms and methods of medical care to patients with this pathology.AimTo study incidence rate of psychosomatic disorders in primary health care, to develop algorithm of medical care.Material and methodsA total of 2010 patients of the primary health care unit were examined. Methods used: clinical-psychopathological, clinical-dynamic, questionnaire screening, statistical (factor analysis).ResultsMental disorders, co-morbid with physical pathology, constituted 3.9% of the contingent with predominance of psychosomatic disorders–15.6 per 10,000 of the population. Respective from clinical-dynamic structure of psychosomatic disorders three groups of patients were distinguished: in need for consultation by a psychiatrist (22.9%); for course treatment by psychiatrist and subsequent observation by physicians (28%); and for systematic therapy and observation by psychiatrist (49.1%). Patients with psychosomatic disorders addressed general medicine network 1–2 years after onset of mental disorder and 6.4 ± 1.2 years after diagnostics of somatic pathology. Patients had predominantly cardiovascular (37.7%; P < 0.05), respiratory (20.5%), and gastrointestinal diseases (20.9%). Exacerbation of psychosomatic disorder was reliably interrelated with psychotraumatic situation and exacerbation of physical pathology. Introduced algorithm of psychiatric consultation consisted of:– evaluation of mental and physical status;– distinguishing the nosological groups;– choice of therapy;– formation of groups of observation (risk groups in need for course therapy, systematic therapy).ConclusionConsultation liaison psychiatry in general medical institution allows widening accessibility of psychiatric care and makes its provision more cost-effective.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Manchester advanced course in liaison psychiatry

1996 ◽  
Vol 20 (12) ◽  
pp. 736-737
Author(s):  
Alison Puffett ◽  
Bill Williams
Keyword(s):  
Training Programme ◽  
Management Skills ◽  
Case Discussion ◽  
Liaison Psychiatry ◽  
Hospital Patients ◽  
Specialist Knowledge ◽  
The Uk ◽  
Supervision And Training ◽  
Training Opportunities ◽  
And Training

Liaison psychiatry is a relatively new and expanding speciality in the UK. A survey conducted in 1990 revealed widespread inadequacies in the training opportunities and resources in consultation liaison services (Mayou et al, 1990). In spite of a growing recognition of the need for more consultants with designated responsibility for general hospital patients, there is currently no formal training programme and many psychiatric schemes fail to provide satisfactory supervision and training opportunities in liaison psychiatry (House & Creed, 1993). The Manchester University liaison psychiatry course was developed in 1993 and is currently the only advanced liaison training course in the UK. Lasting five days, it provides an opportunity for senior psychiatric trainees to improve their specialist knowledge and to develop clinical, research and management skills in liaison psychiatry. The course does not give a comprehensive review of all aspects of liaison psychiatry but aims to generate ideas and discussion through skills based seminars, case discussion and workshop exercises.

Access to Primary Health Care: A Comparison of the US and the UK

1986 ◽  
Vol 15 (3) ◽  
pp. 293-313 ◽  
Author(s):  
Frank Puffer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Low Income ◽  
Household Income ◽  
Primary Medical Care ◽  
Physician Visits ◽  
Primary Health ◽  
The Us ◽  
The Uk

ABSTRACTThis paper examines the extent to which low household income influences access to primary health care in both the US and the UK. The basic approach is to ask whether, given data about a person's age, sex, and self-reported general health status and history, extra information about whether or not they come from a low-income household adds a statistically significant amount to the probability of their obtaining various amounts of primary medical care. The measure of primary medical care is derived from the number of physician visits and it, along with the other data, is drawn from the 1977 US National Medical Care Expenditure Survey and the 1980 UK General Household Survey. Although the two surveys cover different sample periods, they are similar enough to make comparisons between the two countries possible. The main conclusion drawn from the study is that low household income is not an important determinant of the actual use of primary health care resources. Only with subgroups of the low-income population (UK women and US relatively unhealthy individuals) does there appear to be a statistically significant effect, which is quite small in comparison to other factors.

scholarly journals Origins of a Section: liaison psychiatry in the College

2001 ◽  
Vol 25 (8) ◽  
pp. 313-315 ◽  
Author(s):  
Geoffrey G. Lloyd
Keyword(s):  
Psychiatric Disorder ◽  
General Hospital ◽  
Psychological Problems ◽  
Surgical Patients ◽  
Liaison Psychiatry ◽  
High Prevalence ◽  
Abundant Evidence ◽  
Hospital Patients ◽  
The Uk

Why has liaison psychiatry been slow to develop in the UK? The asylum mentality and the current flight into the community have focused psychiatric resources on chronic psychotic illnesses, neglecting the psychological problems of general hospital patients. Nevertheless, there is abundant evidence that medical and surgical patients have a high prevalence of psychiatric disorder that can be effectively treated with psychological or pharmacological methods.

scholarly journals A history of liaison psychiatry in the UK

2016 ◽  
Vol 40 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Peter Aitken ◽  
Geoffrey Lloyd ◽  
Richard Mayou ◽  
Christopher Bass ◽  
Michael Sharpe
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Psychological Needs ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
International Collaborations ◽  
Hospital Patients ◽  
History Of ◽  
The Uk ◽  
Improving Patient Care

Aims and methodTo record the development of liaison psychiatry in the UK and to summarise the current levels of activity. We also highlight the challenges the specialty may face if it is to develop further. History since the 1970s is reviewed by early pioneers and those involved in the present day, with a focus on the key role played by members of the Royal College of Psychiatrists.ResultsWe describe the development of training guidelines, the publication of joint documents with other Royal Colleges, establishing international collaborations and defining service specifications. We emphasise the importance of collaboration with other medical organisations, and describe successes and pitfalls.Clinical implicationsMuch has been achieved but challenges remain. Liaison psychiatry has a potentially important role in improving patient care. It needs to adapt to the requirements of the current National Health Service, marshal evidence for cost-effectiveness and persuade healthcare commissioners to fund services that are appropriate for the psychological needs of general hospital patients.

Health psychology

2012 ◽  
pp. 1135-1143
Author(s):  
John Weinman ◽  
Keith J. Petrie
Keyword(s):  
Health Psychology ◽  
Health Care ◽  
Rapid Development ◽  
Liaison Psychiatry ◽  
Good Communication ◽  
Hospital Patients ◽  
Health Related ◽  
The Face ◽  
Behavioural Factors ◽  
Primary Focus

Health psychology is concerned with understanding human behaviour in the context of health, illness, and health care. It is the study of the psychological factors, which determine how people stay healthy, why they become ill, and how they respond to illness and health care. Health psychology has emerged as a separate discipline in the past 30 years and there are many reasons for its rapid development. An important background factor is the major change in the nature of health problems in industrialized societies during the twentieth century. Chronic illnesses such as heart disease and cancer have become the leading causes of death, and behavioural factors such as smoking, diet, and stress are now recognized as playing a major role in the aetiology and progression of these diseases. The provision of health care has grown enormously and there is an increased awareness of good communication as a central ingredient of medical care and of the importance of such factors as patient satisfaction and quality of life as key outcomes in evaluating the efficacy of medical interventions. Although health psychology has developed over a similar time period to general hospital/liaison psychiatry and shares some common areas of interest, there are some clear differences between these two fields. Liaison psychiatry has a primary focus on hospital patients, particularly those experiencing psychological difficulties in the face of a physical health problem. In contrast, health psychology has a much broader focus on both healthy and ill populations and on the psychological processes that influence their level of health or their degree of adaptation to disease. Whereas health psychology has been mainly concerned with developing explanations based on theory, for health-related and illness-related behaviour, liaison psychiatry has concentrated on the diagnosis and treatment of either unexplained symptoms or psychiatric disorders occurring in people with medical conditions (see the other chapters in Part 5 of this volume). In this chapter we provide an overview of the main themes and areas in health psychology. Four broad areas of behaviour will be reviewed, namely behavioural factors influencing health, symptom and illness behaviour, health care behaviour, and treatment behaviour. Inevitably such an overview is selective and the interested reader should seek out a more comprehensive introductory text or more in-depth accounts of specific areas.

scholarly journals HEALTH CARE FOR IMMIGRANTS IN THE UNITED KINGDOM: HOW IS THE BRITISH SYSTEM PREPARED FOR SERVICING PATIENTS WHO ARE FOREIGNERS?

2020 ◽  
Vol 553 (4) ◽  
pp. 17-29
Author(s):  
Jacek Imiela ◽  
Maria Strzemieczna ◽  
Mikołaj Pawlak
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Equal Access ◽  
English Speakers ◽  
The United Kingdom ◽  
British System ◽  
Access To Medical Care ◽  
The Uk ◽  
Care System

The article presents solutions that enable access to British health care system by foreigners. The migration situation and health care system in the UK is presented. The actions that have been taken to ensure foreigners get access to medical care are described. According to the law, the Primary Care is free for all patients staying in the UK. Secondary Care is free for patients with ordinary residents status, people who have access to healthcare on the basis of international agreements or immigration health surcharge. In order to enable the use of medical care, for non-English speakers, telephone interpretation is commonly used. The Equality and Diversity Council is dealing with problems related to equal access to medical care. Actions taken in the UK can be a reference point in searching for solutions that can be introduced in Poland to ensure equal access to medical care for foreigners.

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