What is it about?

Liaison psychiatry is experiencing a period of rapid expansion in the UK. This follows cost savings demonstrated by the Rapid Access Interface Discharge (RAID) model of liaison psychiatry in which subspecialties of psychiatry are embedded into general hospital settings with a single point of access. This growth is associated with challenges which may affect the sustainability of liaison services, such as sheer pace of expansion, training issues, staff shortages, skill mix, extended work hours, non-recurrent funding and pressure to justify funding early on in the development of a service.

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Why is it important?

Mental disorders are estimated to account for around 5% of accident and emergency attendances, 30% of acute inpatient bed occupancy and 30% of acute readmissions. Between 150 000 and 170 000 accident and emergency attendances per year in England are attributable to self-harm. Medically unexplained symptoms are thought to account for up to 50% of acute hospital outpatient activity while 13–20% of all hospital admissions and up to 30% of hospital emergency admissions at weekends are related to alcohol consumption in England. Hence mental disorders or comorbid mental illness form a huge bulk of clinical activity in acute hospitals

Perspectives

There is a projected shortage of liaison psychiatrists and liaison professionals to cope with the pace of expansion in the UK. The subspecialty, in the UK, is at risk of becomng a victim of its own success. But with support from acute specialties, it is possible for it to find its groove.

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This page is a summary of: The rise of liaison psychiatry: challenges and implications for sustainability, British Journal of Hospital Medicine, September 2016, Mark Allen Group,
DOI: 10.12968/hmed.2016.77.9.523.
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