The future role of general adult psychiatrists

Abstract

Peter Kennedy and Hugh Griffiths (2001) have convened a timely debate on the role and responsibilities of consultants in general adult psychiatry. They provide an analysis of difficulties in fulfilling this role, including inappropriate general practitioner (GP) referrals, excessive caseloads and increasing stress leading to premature retirement. They provide the jobbing consultants with two models of out-patient practice, both relative to the community mental health team (CMHT). However, they have not considered the potential effect of change currently underway as summarised below.

Transforming mental health wards utilising new technologies?

“…8 Although this has produced efficiencies in medical provision, there have been drawbacks, including fractured responsibility for individual patients resulting in differences in approach, for example, in allowing self-directed recovery. 9 Most services also use assertive outreach teams 10 aimed at keeping ward stays to the minimum and avoiding readmission.…”

New ways of working with primary care: proactive CMHT or polyclinic?

“…4 Referrals are received by the CMHT, with prompt joint multidisciplinar y assessment followed by consultant review, if and when appropriate. The option of discharge back to primary care with advice is considered early, following initial assessment, through a full discussion at the weekly CMHT meeting and consultation with the relevant GP.…”