Utilization pattern of a Canadian psychiatric consultation service

Area of Science:

• Psychiatry
• Hospital Medicine
• Behavioral Science

Background:

• Psychiatric consultations are integral to general hospital care.
• Referrals often originate from medical and surgical services.
• Understanding referral patterns and treatment compliance is crucial.

Purpose of the Study:

• To analyze the characteristics of psychiatric consultations in a Canadian teaching hospital.
• To identify common reasons for referral and primary psychiatric diagnoses.
• To investigate factors influencing patient compliance with ambulatory psychiatric treatment.

Main Methods:

• Retrospective review of 255 psychiatric consultations over one year.
• Data collection on referral sources, reasons for consultation, and diagnoses.
• Analysis of compliance rates for ambulatory psychiatric treatment, defined as first appointment attendance.

Main Results:

• Most consultations originated from medical and surgical services.
• Top referral reasons included parasuicidal behavior, depression, and psychological conflicts impacting physical illness.
• Primary psychiatric diagnoses comprised affective disorders, organic brain syndromes, and transient situational disturbances.
• Of patients referred for ambulatory care, 42.8% complied, with 54% of those attending their first appointment.

Conclusions:

• Psychiatric consultations in general hospitals frequently address serious mental health issues.
• Depression and behavioral disturbances are key reasons for psychiatric referrals.
• Compliance with ambulatory psychiatric follow-up remains a significant challenge, highlighting a need for improved patient engagement strategies.