The chronically mentally ill on a general hospital consultation-liaison service. Their needs and management

The consultation-liaison (C-L) psychiatrist often sees chronic mentally ill patients when they are admitted to the medical-surgical services of the general hospital. Little research has been directed to the special needs and concerns of these patients in the general hospital. This area has become more relevant now that many of these patients are no longer cared for in the safety of the state hospital setting, often making baseline medical histories inaccessible. They have an overall higher mortality rate than the general population, cannot give adequate histories, and their psychotic illness can mask an underlying medical illness. In this preliminary investigation of the problems of this special population, the authors examined the issues concerning nursing needs, length of hospital stay, medical diagnosis, and possible complicating problems encountered during these patients' hospital stays in the setting of an urban university hospital. The authors discuss the implications of the role of the C-L psychiatrist in addressing their patients' acute problems.