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 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 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 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.

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 Are patients self-referring to Lewisham Community Wellbeing (LCW) when advised to do so by the assessment and liaison psychiatry team?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S66-S67
Author(s):  
Gautam Bhatia ◽  
Thileepan Thevarajan ◽  
Jadesh Manivannan ◽  
Danny Majidian
Keyword(s):  
Social Inclusion ◽  
Referral Rate ◽  
The Self ◽  
Referral Process ◽  
Liaison Psychiatry ◽  
Referral Rates ◽  
Community Wellbeing ◽  
The Right ◽  
Secondary Finding

AimsIt is well-recognised by the RCPsych that mental illness is both a cause and consequence of social exclusion, and thus social inclusion is an important part of recovery and leads to better outcomes for patients.The Lewisham Assessment and Liaison team Neighbourhood 4 (A&L N4) is a CMHT service that acts as an intake team for all referrals into secondary care mental health services, with the purpose of assessment and brief intervention. Currently, if a patient is assessed to potentially benefit from our local social inclusion service, Lewisham Community Wellbeing (LCW), they are advised to self-refer. However, there is no follow-up as to whether patients go on to do this.Therefore, this audit aimed to calculate:How many patients are advised to self-refer to LCW (advised referral)How many of these patients make the self-referral to LCW (completed referral)MethodThe electronic notes for patients who were accepted by the A&L N4 team from July to September 2020 were retrospectively analysed to see if an LCW self-referral was advised. A list of these patients was then given to LCW to check whether they had self-referred.ResultA&L N4 worked with 82 patients during the study period. 16 patients were advised to self-refer to LCW- an advised referral rate of 19.5%. There was notable month-to-month variation in the advised referral rate- 29.6% in July vs. 9.4% in September.Of the 16 patients advised to self-refer to LCW, 5 did so- a completed referral rate of 31.3%.ConclusionThe completed referral rate of 31.3% is difficult to interpret given there are no standards in this area. On one hand, the self-referral process as it currently exists is functioning; on the other, some two-thirds of patients are not making the most of a service deemed to be of benefit to their recovery.To improve completed referral rates, efforts should be made to better ‘sell’ LCW to the patient. Potential ways of doing this would be through closer working with LCW- for example, LCW could join the clinical meetings more regularly to discuss new services they offer and feedback any patients A&L has referred. There should also be emphasis on making the self-referral process as straightforward as possible.A secondary finding was the notable monthly variation in advised referral rates. It is important to ensure the A&L team are consistently identifying the right patients for LCW, and again, closer liaison with LCW would help achieve this.

Referral Rate of Admitted Cardiovascular Patients Eligible for Cardiac Rehabilitation in a Private Level 3 General Hospital: A Three-Year Retrospective Study

2019 ◽  
Vol 03 (05) ◽  
Author(s):  
Joseph Marc S. Seguban ◽  
Karen G. Amoloza-De Leon ◽  
Marie A. Barrientos-Regala ◽  
Michelle Q. Pipo ◽  
Noemi S. Pestano ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cardiac Rehabilitation ◽  
General Hospital ◽  
Referral Rate ◽  
Cardiovascular Patients ◽  
Level 3

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.

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 Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 31 (2) ◽  
pp. 38-42
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Sharmin Kauser ◽  
Mekhala Sarkar ◽  
Md Masud Rana Sarker ◽  
...  
Keyword(s):  
General Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Major Depressive ◽  
Consultation Liaison Psychiatry ◽  
The Mean ◽  
Inpatient Units

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42

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