From consultation-liaison psychiatry to integrated care for multiple and complex needs.

Area of Science:

• Psychiatry
• Integrated Care
• Health Services Research

Background:

• Physical/psychiatric multimorbidity is increasingly recognized as the norm in patient care.
• Existing healthcare disciplines are adapting to complex patient needs, often securing more funding than Consultation-Liaison Psychiatry (CLP).
• Current integrated care models, heavily reliant on randomized controlled trials, show limited success for complex multimorbidity.

Purpose of the Study:

• To review current medical approaches to physical/psychiatric multimorbidity.
• To examine methodologies used in managing complex patient needs.
• To propose a novel approach for enhancing the role of CLP in healthcare.

Main Methods:

• Medline search using terms: 'consultation-liaison psychiatry', 'integrated care', 'quality assurance', 'qualitative methodology'.
• Literature review on complexity theory.
• Discussions with health science and sociology professionals.

Main Results:

• Quantitative methods alone are insufficient for addressing multimorbidity; qualitative approaches and complexity theory are essential complements.
• CLP possesses valuable experience in qualitative methods but requires interdisciplinary collaboration to refine techniques.
• Transdisciplinary teams, empirically grounded and transparent, will be crucial for implementing effective interventions.

Conclusions:

• CLP should adopt a more integrated approach, combining quantitative and qualitative research, informed by complexity theory.
• Collaboration with other disciplines is vital for refining CLP's research methodologies and ensuring their validity.
• CLP is well-positioned to lead the transformation towards transdisciplinary healthcare delivery for patients with complex needs.