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.
"Borus et al.  argue that studies of C-L psychiatry's impact ought to be longitudinal and include examination of readmissions, persistence of physical and emotional dysfunction after hospital, adherence to prescribed medical regimens and rehabilitation programs, disability, and lost work days. While there is an extensive international literature on liaison mental health services, Callaghan et al. , in their review of 17 evaluative studies of these services, point out that most investigations examine the structure and process of liaison work, with little attention paid to outcome variables such as compliance with treatment recommendations and patient satisfaction. Furthermore, even in those instances where outcome is considered, patients' views tend not to be solicited. "
[Show abstract][Hide abstract] ABSTRACT: Purpose. Twenty-eight women, referred to C-L Psychiatry during their obstetrical inpatient stay were interviewed six months post-discharge to determine how they experienced the consultation process, whether they recollected and adhered to treatment recommendations, and whether they developed or had a recurrence of mental health problems post-discharge.
Method. Semi-structured telephone interviews were conducted by a psychologist who had not been involved with patient care.
Results. There was strong congruence between reason for referral as stated in psychiatric consult notes and participants' recollections and strong congruence and compliance regarding treatment recommendations. Sixty-four percent of women had concerns regarding mood post-discharge, of whom 66% sought professional help within six months. Participants' recommendations for improving the effectiveness of the C-L service to obstetrical inpatients pertained mainly to sensitivity to patients' feelings, consistency of message and personnel, and post-discharge follow-up.
Conclusions. Obstetrical patients had good recollection of their experience of C-L psychiatry, and post-discharge compliance with treatment recommendations was high. A post-discharge telephone call might further enhance treatment compliance and encourage women who are struggling with mood difficulties to seek help. Contact between C-L psychiatry and patients' primary care physician may also enhance care post-discharge.
ISRN obstetrics and gynecology 07/2011; 2011:456012. DOI:10.5402/2011/456012
"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. "
[Show abstract][Hide abstract] ABSTRACT: Bundling is defined as the aggregation of services to increase effectiveness (i.e., creating synergy of effort). The purpose of this commentary is to review the utilization and potential benefits of bundling in its application to HIV prevention.
Review of the literature to provide a broad perspective on the concept of bundling and specific examples of bundling in HIV prevention. Benefits, challenges and directions are considered.
To be effective, bundling must offer strategic advantage: greater value, less cost. It provides an opportunity to target multiple risk behaviors simultaneously for synergistic gain. Technological advances including rapid HIV tests permit noninvasive sampling in clinical and non-clinical settings. Bundling of HIV prevention provides an opportunity to reach high-risk persons who are asymptomatic and/or may not otherwise seek care by eliminating barriers to prevention.
We must implement programs that work and consider innovative approaches to stem the AIDS epidemic; bundling provides one such opportunity to create an efficient paradigm targeting multiple risk behaviors simultaneously.
Preventive Medicine 04/2008; 46(3):222-5. DOI:10.1016/j.ypmed.2007.09.006 · 3.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Australia, like many other countries that adopted deinstitutionalisation is experiencing increased presentation at emergency departments (EDs) by patients with acute mental health and addiction needs. While different models of psychiatric
emergency care have been utilised within EDs little is known about the effectiveness of the care provided or how they work on a day-to-day basis.
Psychiatric Emergency Care Centres (PECCs) is one of these new initiatives. PECCs aim to improve patient flow in urban EDs by providing a rapid pathway to specialist mental health assessment and care. St Vincent hospital in Sydney opened a 6 bed PECC service in 2005. It is co-located with ED and staffed 24 hours a day
by registered mental health nurses supported by psychiatric and emergency teams. The service has two components - a short term stay unit and an ED liaison role. The nurses work closely with community mental health teams, inpatient units, general practitioners, non-government agencies and other hospitals. This thesis evaluated the organisational and operational aspects of this PECC service using a processimpact evaluation. Documents, existing clinical records and interviews with nurses in the PECC and ED and with a consumer representative were used as data sources to describe the service and identify what was working well and what could be improved. The research found that the service has provided additional resources and collaboration between ED and mental health services. In addition the research found that PECC is an effective service catering to the needs of consumers and providing
access to mental health specialist clinicians. Since PECC was established there has been an increase in assessments conducted within the ED and an increase in the numbers presenting to ED for mental health reasons from 2833 in 2006 to 4987 in 2008, but the number of admissions to PECC have remained relatively stable at 693 and 714. Aspects of the service that worked well included the rapid assessment and management of acutely unwell people by the PECC nurses. Aspects that were problematic concerned the ability of the service to address social issues and the
management of people with behavioural, alcohol, substance intoxication or selfharm behaviours. Areas for enhancing the service include being more consumers responsive, increasing the skills and knowledge of staff and undertaking further
research regarding the needs of people who use the service.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.