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Consultation-liaison psychiatry in general practice
V J Carr1, T J Lewin, J M Walton
1Disciplines of Psychiatry and General Practice, Faculty of Medicine and Health Sciences, University of Newcastle, Callaghan, Australia.
The Australian and New Zealand Journal of Psychiatry
|February 1, 1997
Summary
This study analyzed 303 referrals to a consultation-liaison psychiatry service in Australian general practices. Key findings indicate a need for enhanced general practitioner (GP) training in managing mild mental health conditions and improving referral processes.
Area of Science:
- Psychiatry
- General Practice
- Mental Health Services Research
Background:
- Consultation-liaison (C-L) psychiatry services bridge primary care and specialist mental health support.
- Understanding referral patterns and patient characteristics is crucial for optimizing C-L service delivery within general practices.
Purpose of the Study:
- To characterize 303 consecutive referrals to a C-L psychiatry service embedded in eight group general practices.
- To analyze referral reasons, psychiatric diagnoses, and clinical management outcomes.
- To compare referred patients with non-referred general practice attenders.
Main Methods:
- A 12-month service audit using a purpose-designed form collected demographic data, referral reasons, diagnoses, and management details.
- Prospective outcome evaluation involved structured interviews and questionnaires for a subset of patients.
- Comparative analysis was conducted between referred (n=303) and non-referred (n=535) patients.
Main Results:
- Top referral reasons included depression (33%), anxiety (12%), and diagnostic assessment (9%).
- Most common diagnoses were mood disorders (29%), mild/transient conditions (29%), and anxiety (14%).
- General practitioners (GPs) remained involved in 53% of treatments, but 44% of referrals were redirected to other mental health agencies.
Conclusions:
- The diagnostic profile of C-L service users differed from general hospital psychiatric services, with fewer organic brain syndromes and suicide risk evaluations.
- There is a need for improved GP psychiatric education, better screening for patients with mild, transient conditions, and strategies to support GP management of these cases.