RAID: A model of psychiatric liaison in general hospitals

摘要

Liaison psychiatry provides mental health treatment in general hospitals, for visitors to emergency departments and outpatient clinics, and patients admitted to wards (Barrett et al. 2015). This service has been developed in response to evidence of the high proportion of patients with mental and physical comorbidity (Parsonage and Fossey, 2011). Reports show that just over a quarter of inpatients in general hospitals have a diagnosable psychiatric disorder (Plumridge and Reid, 2012), and among elderly patients up to 60% will have or develop a mental disorder during their admission (Parsonage and Fossey, 2011). People attending emergency departments due to mental health problems is 5%, with self-harm being the most predominant, accounting for over 200 000 attendances per year (Cooper et al, 2015). Additionally, 12% of accident and emergency (A&E) attendances and 6.2% of all hospital admissions were due to alcohol-related problems (Pirmohamed et al, 2000). The government's mental health strategy in 2011 highlighted the importance of improving the interface between physical and mental health services (HM Government, 2011). In spite of this, liaison psychiatry is available in only 16% of England's 179 acute hospitals (Mental Health Taskforce, 2016). Of those that do exist, it has been identified that services across England are patchy, with variations in service models (NHS Confederation, 2011).