All UK hospitals ‘must have liaison psychiatry services’

Embargoed until 28 July 2009

Every hospital in the UK must have a dedicated liaison psychiatry service, according to a new report from the Academy of Medical Royal Colleges.

The report, No Health Without Mental Health, warns that the current lack of provision means the mental health problems of many hospital patients are going unrecognised and untreated – causing them unnecessary suffering.

Figures show that one in four people who attend hospital for physical health needs will have a mental health problem. For patients over the age of 65 these figures are even higher, with 60% requiring mental health care during their hospital stay. At present however, around 40% of hospitals have no access to liaison psychiatry services.

Adequate liaison psychiatry services are multi-professional teams made up of nurses, psychiatrists, psychologists, social workers and occupational therapists. Liaison professionals are specially trained to bridge the gap between psychiatry and medicine by diagnosing mental illness, arranging appropriate psychological treatment, and providing expert advice and support to medical colleagues. Liaison psychiatry teams have been shown to improve outcomes, reduce patient suffering and make significant financial savings to Primary Care Trusts.

Professor Else Guthrie, author of the report, said:

“When mental and physical health problems combine, the individual is more likely to experience physical complications and problematic symptoms. They are less likely to access services and adhere to treatment, and their physical and mental recovery can be seriously impeded. These complications result in greater lengths of stay, higher numbers of re-admissions, and increased healthcare expenditure. The fact that many hospitals lack liaison psychiatry input means that patients are not getting a fair deal and that precious NHS resources are not being best utilised.”

A patient named Jackie describes the impact a liaison psychiatry team had on her:

“I went into my first consultation with trepidation, but after 6 sessions I understood the effect my physical illness was having on my life and that of my family. This was the first step to learning to live with my illness and accept my new life. Obviously liaison psychiatry cannot change everything about the physical illness, but it really helped me understand that some of the symptoms were borne of my own fear and ignorance and I learned how to control them. I did not go back into hospital for those symptoms again. All patients who are seriously debilitated after illness or through disease should have access to liaison psychiatry; it is a false economy not to do so. It would have helped me massively if I had been seen by a liaison psychiatrist at least three years earlier.”

Liaison services are not just valuable to patients; they are appreciated by other hospital professionals. Dr Guy Sanders, a Consultant in Emergency Medicine and contributor to the report, added:

“Liaison psychiatry services can be very helpful to other hospital professionals in providing specialist training and support, improving understanding of mental health, promoting best practice and reducing discrimination and stigma.”

No Health without Mental Health argues that until adequate liaison psychiatry services are explicitly and adequately commissioned to every general hospital, patients and healthcare professionals will continue to suffer.

References:

The No Health without Mental Health work was commissioned by the Academy of Medical Royal Colleges and undertaken by the Royal College of Psychiatrists, as part of their Fair Deal campaign www.fairdeal4mentalhealth.co.uk

Note to editors:

Two documents have been produced; the ALERT summary report and a more detailed report No Health without Mental Health: the evidence. Both reports focus on the mental health needs of people with physical health problems, the physical health needs of people with mental health problems and the needs of people with learning disabilities. The No Health without Mental Health reports, along with educational materials and further information, are freely available on www.rpcysch.ac.uk/nohealth To support this work, the Royal College of Psychiatrists has established an accreditation network for liaison mental health services. This network will enable liaison teams to demonstrate (and improve) the quality of their service against agreed quality standards. See www.rcpsych.ac.uk/PLAN. This work has also been endorsed by the Royal College of Nursing and the Royal College of General Practitioners.