Who sees a psychiatrist? A study of factors related to psychiatric referral in the general hospital

Pritchard, Michael

doi:10.1136/pgmj.48.565.645

Cited by 14 publications

(12 citation statements)

References 4 publications

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“…Authors of this study attributed this to a lack of strategies for detailed suicide prevention in Korean emergency departments and possible prejudice towards psychiatric consultation. This was supported by the fact that studies in countries other than South Korea had found suicide attempts to be predictive of referrals [37]. …”

Section: Resultsmentioning

confidence: 92%

“…Collaborative screening of inpatients [34]Decrease CLP referral1. Lack of detailed suicide prevention strategy [36, 37]2. Poor CLP communication [32]Unclear influence1.…”

Section: Resultsmentioning

confidence: 99%

“…In a study by Pritchard in 1972, patients with a psychiatric history are three times more likely to be referred for psychiatric consultation. However, Pritchard suggested that if the patient had previous contact with the psychiatric team in the same hospital, they might not be referred to CLP [37]. This was supported by lowered referral rates for patients with previous psychiatric contact in same hospital but did not reach statistical significance (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Functional psychosis [37]Decrease CLP referral1. Organic psychosis [37]2. Previous psychiatric contact at same hospital [37]Unclear influence1.…”

Section: Resultsmentioning

confidence: 99%

“…Organic psychosis [37]2. Previous psychiatric contact at same hospital [37]Unclear influence1. Personality disorder (earlier referral) [62]2.…”

Section: Resultsmentioning

confidence: 99%

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Why are hospital doctors not referring to Consultation-Liaison Psychiatry? – a systemic review

2016

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BackgroundConsultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature.MethodsWe searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included.ResultsThirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis.ConclusionThis is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

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Section: Resultsmentioning

confidence: 92%

“…Collaborative screening of inpatients [34]Decrease CLP referral1. Lack of detailed suicide prevention strategy [36, 37]2. Poor CLP communication [32]Unclear influence1.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%