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).

scholarly journals An audit: fitness to drive assessment in inpatients of general adult and old age psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S200-S201
Author(s):  
Ismail Khan ◽  
Nneamaka Asiodu ◽  
Dr Divyanish ◽  
Anum Yaqoob ◽  
Hasanain Qureshi
Keyword(s):  
Old Age ◽  
Social Withdrawal ◽  
Data Collection Tool ◽  
Fitness To Drive ◽  
Good Medical Practice ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Duty To Inform ◽  
The Impact ◽  
Physical Health Screening

AimsTo determine if fitness to drive is assessed on admission and discharge, if applicable, and for this to be documented during clerking and on discharge notifications.To determine if patients are being educated about the impact of their condition on the ability to safely drive.To ascertain if patients are aware of the duty to inform the DVLA if they for any reason are not fit to drive.BackgroundRisk factors include social, behavior and iatrogenic factors such as social withdrawal, increased likelihood of substance abuse and side effects of anti-psychotic medication.MethodThis trust wide audit involved the random sampling of a total of 71 case notes, 4 case notes per Consultant team in general adult psychiatry and old age psychiatry across Dudley and Walsall sites (total of 3 sites). A data collection tool was developed and included relevant questions regarding fitness to drive. Data were collected between October and December 2019.Result18/49 patients had physical health screening prior to medication initiation.ConclusionAn important aspect of good medical practice is to educate patients about their condition, this includes their fitness to drive as this can be affected both by their diagnosis and medication. It is clear that clinicians also need to be educated about this responsibility to ensure assessment is performed especially on inpatient discharge.

Principles of service provision in old age psychiatry

2020 ◽  
pp. 281-306
Author(s):  
Tom Dening ◽  
Kuruvilla George
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Religion And Spirituality ◽  
Liaison Psychiatry ◽  
Memory Assessment ◽  
Challenges And Opportunities ◽  
Recent Developments ◽  
Old Age Psychiatry ◽  
Consultation Liaison Psychiatry

Globally increasing numbers of older people bring both challenges and opportunities for old age psychiatry services. This chapter outlines the history, underlying principles, and policy context for contemporary mental health services for older people. It discusses components of services, including community health teams, memory assessment services, consultation-liaison psychiatry, and in-patient mental health care, as well as newer types of service, such as crisis teams and outreach to care homes. Other recent developments include various models of case management and emphasis on post-diagnostic support. Equally important are issues of equality and access, and the chapter covers several key areas, such as age, gender, sexual orientation, religion and spirituality, and rurality. Major challenges to old age psychiatry come from limited resources and non-recognition of the distinct needs of older adults, as well as the demands of the growing older population, advances in science and technology, and the need to attract talented psychiatrists into this field.

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.

Teaching and training in old age psychiatry: a general survey of the World Psychiatric Association member societies

2003 ◽  
Vol 18 (8) ◽  
pp. 694-699 ◽  
Author(s):  
Vincent Camus ◽  
Cornelius Katona ◽  
Carlos Augusto de Mendonça Lima ◽  
Addul Moneim Abdel Hakam ◽  
Nori Graham ◽  
...  
Keyword(s):  
Old Age ◽  
General Survey ◽  
Association Member ◽  
The World ◽  
Old Age Psychiatry ◽  
And Training

From Consultation—Liaison Psychiatry to Psychosocial Advocacy: Maintaining Psychiatry's Scope

1998 ◽  
Vol 32 (6) ◽  
pp. 753-761 ◽  
Author(s):  
Graeme C. Smith
Keyword(s):  
Health Care ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Discharge Planning ◽  
Liaison Psychiatry ◽  
Health Care Administrators ◽  
Medline Search ◽  
Admission Screening ◽  
The Status ◽  
Literature Base

Objective: To review the status of consultation-liaison (C-L) psychiatry and the forces shaping it, and to propose strategies for dealing with the crisis in which it finds itself. Method: A Medline search of C-L psychiatry and related terms, together with hand-searching of C-L psychiatry and psychosomatic journals and bibliographies of found articles, was used for the literature base. The experience of membership of the committees of national and international C-L psychiatry organisations and their interaction with health care administrators was used as the basis for the discussion of strategies. Results: It is argued that patients with physical/psychiatric comorbidity and somatisation have been marginalised by application of narrow definitions of what constitutes ‘serious mental disorder’ in the public sector. Evidence is presented to support the argument that physical/psychiatric comorbidity is the most common form of psychiatric presentation in the community, that such comorbidity has serious consequences in terms of morbidity, mortality and health-care costs, and that even subthreshold psychiatric symptoms have serious implications when physical comorbidity exists. Conclusion: It is concluded that a number of strategies, including pre-admission screening, integrated discharge planning, liaison, as well as shared care with general practitioners, advanced training in C-L psychiatry and more research to establish practice guidelines, are required if psychiatry is to remain a broad-based discipline rather than retreat to being a specialty for psychosis. Consultation-liaison psychiatrists must become the advocates for the psychosocial system.

Liaison old age psychiatry

2020 ◽  
pp. 347-360
Author(s):  
Fiona Thompson ◽  
Elena Baker-Glenn
Keyword(s):  
Old Age ◽  
Older Adult ◽  
Screening Tools ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Old Age Psychiatry ◽  
The Uk ◽  
Hospital Team

Liaison psychiatry is a sub-specialty of psychiatry that specializes in the interface between physical and mental health, and involves treating patients who are attending general hospitals. This chapter provides an overview of the development of old age liaison psychiatry with consideration of the commissioning and funding of services. It discusses the importance of liaison psychiatry services being integrated within the general hospital team. It outlines different models of liaison psychiatry and provides examples of different services in the UK. It describes common conditions seen within older adult liaison psychiatry and considers screening tools and outcomes. Finally, it covers other aspects of the role of liaison psychiatry, such as teaching, training, governance and accreditation of services and considers interfaces with other services and the future of liaison psychiatry.

EPA-1801 – Diagnosis, management and referrals to old age liaison psychiatry of delirium in a general hospital

2014 ◽  
Vol 29 ◽  
pp. 1
Author(s):  
D. Adamis ◽  
S. Rooney ◽  
M. Qadir ◽  
G. McCarthy
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Liaison Psychiatry

scholarly journals Higher training in liaison psychiatry for older adults: experiences of two specialist training posts

2007 ◽  
Vol 31 (9) ◽  
pp. 354-356
Author(s):  
Maura Young ◽  
Siobhan Morris
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
General Hospital ◽  
Old Age ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Liaison Psychiatry ◽  
The Past

Over the past decade, old age liaison psychiatry services have been developing across the UK. The driving force behind this has been the recognition of the inequity in service provision for people over the age of 65 with mental health problems in a general hospital setting. A postal survey of consultants in old age psychiatry in April 2002 showed that most respondents (71%) considered that the service they provided to older people in general hospitals was poor and needed to be improved (Holmes et al, 2002). Much work has been done to highlight this issue, and liaison psychiatry for older adults is gaining prominence. The national conference on liaison psychiatry for older people, which has been held in Leeds for the past 4 years, attracts large numbers of enthusiastic participants. The Department of Health (2006) document A New Ambition for Old Age specifically mentions the current poor standard of care that older people with mental health problems receive in a general hospital setting. The Royal College of Psychiatrists (2005) has produced guidelines for the development of liaison mental health services for older people.

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