A social systems approach to consultation-liaison psychiatry

Consultation-liaison psychiatry traditionally has emphasized an approach to clinical practice based upon an understanding of the ways in which intrapsychic dynamics, personality characteristics and biological phenomena interact in a process that can be understood to relate to symptoms and disease in the individual. More recently the field has considered the interaction of interpersonal and group phenomena with individual characteristics and their influence upon patient pathology. Currently, however, there is limited understanding of the significance of organizational variables for the work of the consultation-liaison psychiatrist. In this paper, several organizational themes are discussed in terms of social systems theory and the relevance of these themes are applied to case material taken from a year's experience of consultation-liaison in a hemodialysis unit of a general hospital (HUGH).