Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-pkshj Total loading time: 0.604 Render date: 2021-11-28T15:54:22.550Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Thoughts on the development of liaison psychiatry services in London

Published online by Cambridge University Press:  02 January 2018

Adetokunbo Bamidele Shangobiyi
Affiliation:
Tees, Esk and Wear Valleys NHS Foundation Trust, Durham, email: adetokunboshangobiyi@nhs.net
Itoro Ime Udo
Affiliation:
Mersey Care NHS Trust, Liverpool
Rights & Permissions[Opens in a new window]

Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2015

The clear strength of Naidu et al's paper Reference Naidu, Bolton and Smith1 is its attempt to map the development of liaison services in London over the past 8 years. The authors have also appraised the various models of liaison services. It was interesting to see which models have been adopted in Greater London as well as the variations that exist, including the absence of a liaison service in one trust.

When we were reviewing policy documents, Reference Aitken2 it has caught our attention that recommended staff numbers have not changed since they were first proposed by the Royal College of Psychiatrists in 2007. The context for this observation is the continuing reduction in acute bed numbers as well as increased recognition of the need to promptly identify and treat psychiatric comorbidities in acute settings. These developments would have been expected to affect liaison psychiatry team sizes and/or structure. It may well be that these changes have balanced themselves, hence unchanged staff numbers recommendations.

Also, treatments which would normally be given in acute hospitals are being gradually moved into the community. One would have expected that there should be a corresponding development in community liaison services to facilitate good healthcare, but this has not materialised.

Evidence suggests that untreated mental illness is associated with an increase in hospital bed days. Reference Saraway and Iavin3 Depression and anxiety, for example, are likely to increase the numbers of days spent in an acute hospital bed. Reference Pollack and Alovis4 Hence, it would appear that benefits accrue to acute trusts where there is a liaison service on-site. This may be an impetus for acute trusts to fund the establishment of liaison services within their set-up, but this has generally not been the case, as Naidu et al's paper illustrates.

To bring the study up to current standards, it would have been interesting for London services to have been compared against the RAID liaison psychiatry model which is now accepted as effective and efficient. Reference Aitken, Robens and Emmens5 It proposes three consultants, which is an increase from the Royal College's recommendation of only one consultant.

Naidu et al suggest that demographics could possibly have had an influence on the variation in the commissioning of liaison services. For example, there may have been greater need in certain areas for particular services for older adults.

We think Naidu et al's paper would be of interest to commissioners, as it illustrates how service models have developed, with funding but without corresponding investments in the community side of liaison services, to facilitate present government policy of moving care into the community.

References

1 Naidu, S, Bolton, J, Smith, J. London's liaison psychiatry services: survey of service provision. BJPsych Bull 2015; 38: 65–9.Google Scholar
2 Aitken, P. Mental Health Policy Implementation Guide: Liaison Psychiatry and Psychological Medicine in the General Hospital. Royal College of Psychiatrists, 2007.Google Scholar
3 Saraway, SM, Iavin, M. Psychiatric Comorbidity and Length of Stay in the General Hospital: A Critical Review of Outcome Studies. Psychosomatics 1994; 35: 233–52.Google Scholar
4 Pollack, S, Alovis, N. Psychological Comorbidity and Length of Stay in the General Hospital. Am J Psychiatry 1991; 148: 324–9.Google Scholar
5 Aitken, P, Robens, S, Emmens, T. (eds) Developing Models for Liaison Psychiatry Services – Guidance. Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions South West, 2014.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.
You have Access
Open access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Thoughts on the development of liaison psychiatry services in London
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Thoughts on the development of liaison psychiatry services in London
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Thoughts on the development of liaison psychiatry services in London
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *