This paper describes the experience of providing on-the-spot psychiatric consultations to medical and surgical clinics. Data on the first 100 referred patients are presented, patterns of referral and outcome of the consultations discussed. The following postulates are offered. The presence of psychiatric consultants in the medical and surgical clinics is desirable in the interest of more efficient care of patients with psychiatric disorders, who reportedly comprise at least half of clinic populations. The aim of the consultant in this setting should be to facilitate better management of psychiatric problems by the non-psychiatrists and to prevent, as far as possible, automatic and often belated, referrals to the psychiatric clinic. Proper use of psychiatric consultants should be stressed to the medical students and residents. More attention should be devoted to the improvement of the techniques of psychiatric consultations to increase their still inadequate efficacy. Consultants should be members of an organized pyschiatric consultation service which would ensure their optimum performance. We predict that the future introduction of comprehensive medical care will make such a service an economic necessity in every general hospital.
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