Assessment of patient-staff and intrastaff problems in psychiatric consultations

In a study of 249 consecutive inpatient consultations, the occurrence of patient--staff or intrastaff problems as determined by the psychiatric consultation team was compared with questionnaire answers, provided by the consultant following each consultation, and interpreted as indications for such staff problems. According to the consultation team, staff problems played a role in 33% of the consultations. In the questionnaires, of the nine criteria statistically significantly related to the occurrence of staff problems, the following were the most relevant: 1) emotional tone or wording of request; 2) abnormal timing of referral; 3) request unclear; 4) unjustified urgency of referral; and 5) existence of hidden questions. If none or only one of these criteria were positive, then there was little chance that staff problems were present. If three or four criteria were positive, then the probability of staff problems was much higher. If the first three criteria were negative, then staff problems were hardly ever encountered.