A review of research on the structure, process and outcome of liaison mental health services

Abstract

Liaison mental health services (LMHS) developed originally to address the mental health needs of people with physical illnesses in general hospitals and more recently to work also with people with mental health problems presenting at non-mental health services. The purpose of the present paper was to review empirical research on the structure, process and outcome of liaison mental health services using systematic review methods. Following a comprehensive search strategy, the authors reviewed 48 papers published between 1975 and 2001. There is an extensive international literature on LMHS, much of which describes the structure and process of liaison work. Studies evaluating the outcomes of liaison mental health services are fewer, and handicapped by methodological flaws, some of which are serious enough to cast doubts on the reported results. Professionals and clients value LMHS. LMHS based in accident and emergency (A & E) departments appear to ease the burden of general A & E staff, help clients access mental health services and reduce re-admission rates of people with mental health problems. There is little evidence supporting one model of configuring LMHS over another.

Emergency Department Recognition of Mental Disorders and Short-Term Outcome of Deliberate Self-Harm

“…In one of the previously mentioned U.K. studies, a similar but statistically nonsignificant trend was reported toward lower psychiatric hospital admission rates among self-harm patients who Our findings provide empirical support for calls to increase access to mental health services in the emergency department management of deliberate self-harm. Some potential strategies for improving access to mental health evaluations in emergency departments include training emergency staff in assessment and acute management of self-harm (25), developing liaison services with mental health specialists (26), and integrating mental health teams into the emergency department service (27).…”

“Bundling” HIV prevention: Integrating services to promote synergistic gain

“…Perhaps the earliest (documented in 1751) and best established form of bundling is use of liaison mental health services: integrating mental health services into hospital and clinic settings where patients sought care for physical illness (Callaghan et al, 2003). Within psychiatric treatment, HIV prevention has also been bundled.…”

Clinical outcome and predictors of adverse events of an enhanced older adult psychiatric liaison service: Rapid Assessment Interface and Discharge (Newport)

“…Such models could be slow in response due to lack of capacity, thus becoming essentially a reactive model of care. Systematic reviews favor the liaison model being more effective at improving clinical outcomes in older people compared to the consultant-led model but fail to identify strong evidence to guide service provision 17–19. There is little evidence to support that psychiatric liaison models for acute older people admitted to hospitals during normal working hours (9 am to 5 pm) are cost effective and beneficial 18,20,21.…”