Establishing a Geriatric Psychiatric Consultation in a VA Medical Center

The authors describe the establishment of a Geriatric Psychiatry Consultation-Liaison Team (GPCLT) at a Veterans Administration Medical Center (VAMC) that previously had no organized geriatric psychiatric service. Geriatric psychiatric consultation was required by three intermediate-care units treating older, chronically medically ill veterans with psychiatric symptoms or disorders. The GPCLT comprised a black, female geriatric psychiatrist and a white, male social worker. This combination of disciplines maximized skills, and the ethnic-gender differences of team members addressed questions of racial tension and gender issues between patients and VAMC staff members. The compliance with recommendations of the GPCLT, ranging from 89% to 98% across the three units, its selection as a clinical site for a university-affiliated Geriatric Psychiatry Fellowship Program, and the increase in the total hours of social work time assigned to the GPCLT documented the positive perception of the team by both the VAMC and the affiliated university. Specific recommendations are presented for consideration by other, similar settings.