Sunday, January 21, 2007

What is Liaison Psychiatry?

Recently, I was asked by a reader "what is liaison psychiatry?" Liaison psychiatry is a unique specialty providing psychiatric treatment to patients attending general hospitals, dealing directly at the interface between mental and physical health. Specific liaison psychiatry services were set up in the 1970's and in 1997 liaison psychiatry was recognised as a distinct Royal College of Psychiatry Facualty.

The requirement for liaison psychiatry is evident from the high prevalence of psychiatric disorders within the general hospital setting. In fact, the prevalence of psychiatric disorders amongst general hospitals patients is much higher than the general population[1]. Epidemiological studies have revealed that the prevalence of mental disorders in general hospital inpatients range from 41.3% to 46.5%[2]. It has been reported that unless a specific liaison psychiatry service exists within the general hospital, a significant proportion of psychiatric co-morbidity remain undetected and untreated[3]. To add to this, advancements in medical technology such as, intensive care treatment, organ transplantation and cardiac surgery[2] have had an important knock on effect, increasing the workload for liaison psychiatry.

[1] Department of Health 1994
[3] Mental Disorders in General Hospital Patients Rothenhausler HB. Psychiatr Danub. 2006 Dec;18(3-4):183-92.
[3] Business Case For Consultation-Liaison Psychiatry Service Southampton (Peveler, Kenwood, Martin; August 1995)


QUASAR9 said...

Hi Michelle,
Glad to see you have Liaison Psychiatry for inpatients

Perhaps we also need Liaison dentistry - with hospitals offering to address the problems faced by patients who can't get adequate treatment, or have complications following treatment.

Not much use the maxillo-facial or pain clinic in a hospital, thinking the dentists in the community can address the problem.

When dentists refer patients to a hospital, because a problem isd beyond their skill and abilities, or budget - it serves little purpose if when they fibnally get an appointment at the hospital - the Consultant is impatient because he feels his time is being wasted. It is the patient that is in great pain and discomfort and it is the patient has every right to be impatient with a system that is geared to removing teeth, or letting teeth get to such a state that removal is the only option.

By not addressing the things that can be fixed, not with money, but with time - the nhs is failing people, by peromising instead that they can deliver improvements or miracles in the future.

Dr Michelle Tempest said...

Thanks quasar9. Liaison dentistry is a great idea and I have seen many patients come to A&E with tooth ache - I suspect a liaison dentist would have been of great help.
As for money - money is currently the cause some liaison psychiatry units are under threat. Despite clinical evidence illustrating 'clinical need', the question may well be whether the budget holders will continue to fund the service.