This guidance provides the case for change in relation to the development of liaison psychiatry services from the current heterogeneous patchy collection of rudimentary to gold standard services and sets the minimum service specifications required to achieve the cost and quality outcomes suggested by the evaluation of Rapid, Assessment, Interface and Discharge (RAID).
It also contains advice to commissioners on how to optimise the models to fit with local service pathways and demand. The four effective models are termed Core, Core24, Enhanced24 and Comprehensive.
Defining liaison psychiatry
Liaison psychiatry, also known as Psychological Medicine, is the medical specialty concerned with the care of people presenting with both mental and physical health symptoms regardless of presumed cause. The specialty employs the bio-psychosocial model being concerned with the inter-relationship between the physiology, psychology and sociology of human ill health.
Liaison psychiatry services are designed to operate away from traditional mental health settings, in the main in general hospital emergency departments and wards, and medical and surgical outpatients.
Liaison psychiatry teams are multidisciplinary, clinically led by a consultant liaison psychiatrist who will have higher specialty training in general adult psychiatry with sub specialty endorsement in liaison psychiatry. Many liaison psychiatrists will also have higher specialty training in general medicine or general practice.
Liaison psychiatrists, as well as being in a position to diagnose and prescribe, can also formulate and deliver brief psychotherapeutic interventions most commonly cognitive behavioural therapy or psychodynamic interpersonal therapy.
The multidisciplinary liaison psychiatry team will typically include specialist mental health nurses, psychological therapists, occupational therapists and social workers.
Liaison psychiatry services hold expert knowledge on the safe operation of the mental health act in general health settings and provide expertise to capacity assessments.
This guidance is part of a suite of four related documents, each with increasing levels of detail:
- Liaison Psychiatry Services – Guidance – sets out the key consideration to be made when commissioning liaison psychiatry services.
- An Evidence Base for Liaison Psychiatry – Guidance – sets out the evidence gathered from lay people, professionals, commissioners and the literature about what is needed from liaison psychiatry services.
- Developing Models for Liaison Psychiatry Services – Guidance – provides the technical information needed for commissioning liaison psychiatry services.
- Model Service Specifications for Liaison Psychiatry Services – Guidance – sets out exemplar service specifications for four models of liaison psychiatry.
This guidance was commissioned by the Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions South West.