Best Practices: The Consultation-Liaison in Primary-Care Psychiatry Program: A Structured Approach to Long-Term Collaboration

Abstract

This column presents the Consultation-Liaison in Primary-Care Psychiatry model, which was developed in Australia. This model is a structured approach to collaborative care of people with mental illnesses between primary care services and specialist mental health services. The first component of the model is a consultation, liaison, and education service provided by psychiatric consultants at participating general practices. The second component involves transferring selected patients from community mental health services into general practitioner-based collaborative care. In the final component a clinical case-register and reminder system managed by the specialist services is used to actively promote follow-up for transferred clients. The column also offers some evidentiary support for this care model that suggests a best-practices model for maintaining adequacy of care for patients.

A worked example of initial theory-building: PARTNERS2 collaborative care for people who have experienced psychosis in England

“…The research literature on collaborative care and personal recovery provided the foundational structure for the components and key content of the IPT. Social science theory, including the Chronic Care Model (Wagner et al, 1996) and a conceptual framework for personal recovery in mental health (Leamy et al, 2011), with research evidence about collaborative care (Bauer et al, 2006; Chatterjee et al, 2014; Druss et al, 2001; Kilbourne, 2008; Meadows et al, 2007; Reilly et al, 2013; van der Voort et al, 2015; Waxmonsky et al, 2014), supported our aim to follow the fundamental principles of collaborative care optimised for people with experience of psychosis, where there was evidence of potential benefit.…”

H2M: a GP-focused multidisciplinary team for patients living with HIV and hepatitis C

“…H2M was inspired by the Consultation Liaison in Primary Practice (CLIPP) model used in Victoria. 9 Patients are allocated at a weekly meeting using a faxed referral form to assist in triage; this method is used to create a ‘no wait’ referral process. The clinician proactively contacts the patient directly to offer an appointment, and the patient is then assessed and a suggested treatment plan is developed.…”

Ways of working at the interface between primary and specialist mental healthcare

“…7 A collaborative-care model for people with longer-term mental health problems discharged back to primary care in Australia showed no deterioration in outcome compared with those who remained in a mental health service. 8…”