What is liaison psychiatry? 

Liaison psychiatry aims to bridge the gap between physical and mental healthcare. Find out how this mental health service works.

Guide to mental health services

Transcript of What is liaison psychiatry?

WHAT IS LIAISON PSYCHIATRY?

STEVEN REID CONSULTANT LIAISON PSYCHIATRIST

ST MARY'S HOSPITAL

Many of the services we provide in the NHS split physical from mental health.

What we do in liaison psychiatry

is try and bring the body and the mind back together again.

People come to hospital for help with symptoms

and commonly physical and psychological symptoms occur together.

If someone is struggling with a chronic, painful illness, like arthritis,

it comes as no surprise to us that they might feel low or depressed.

If you have diabetes and you are depressed or anxious

that will have an impact on how you manage your illness.

There is good evidence that psychological interventions

can lead directly to improved control of your blood sugar.

It's also more than just providing a shoulder to cry on.

People that we see often lose hope and feel at the end of their tether

and a good intervention by liaison psychiatry can be life saving.

Of course, this doesn't just apply to the work we do in hospital,

but also to the wide community, too.

(woman) I've worked at St Mary's Hospital for a number of years now.

Both as a consultant and as a more junior doctor.

During that time in A&E

we've had the advantage of having a liaison psychiatry service there.

It has affected me in a number of ways.

Both in terms of their help with dealing with

our general emergency medicine patients,

who we don't think have got mental health problems,

and those who come into hospital who clearly do have a mental health problem.

We particularly have a large number of patients who come to the hospital

because they are victims of major trauma.

We're a major trauma centre

and we see a number of patients who have mental health problems

and have injured themselves in terms of self harm

and those who've suffered psychological problems because of their injuries.

We can always get hold of a member of the team.

We can discuss any problems with them

and they are, essentially, on site to provide us with support 24-7.

(woman) I was referred a long time ago.

Now I am eight and a half months of pregnancy

and from the first weeks when I got pregnant,

I went to GP and I was in that kind of mood.

She told me, "This is depression,

which, long time ago, is nothing to do with the pregnancy."

With pregnancy, I believe, it's just become more sensitive,

but... yeah.

And I got these pills and even from the first day, I feel relaxed.

(man) It's very difficult when they're so separated,

when quite often they are needed to work in conjunction with each other.

Makes life harder on the doctors

and it makes it harder for the mental health teams to treat you as well.

(woman) When we were first in touch with the liaison psychiatry,

they were such a breath of fresh air, quite honestly,

because when they phoned up to make the appointment, they said,

"We can see that your husband has a lot of physical needs,

how about if our doctor phoned him up and we spoke to him over the phone,

instead of him having to trek here to see us?"

Even before speaking to that doctor,

that made a huge impression on both my husband and I.

(man) Well, I was in big crisis. I was actually feeling suicidal.

If I could have done, I would have harmed myself.

(woman) It got to the point where we really didn't know

where else to turn for help within the hospital system.

They didn't know what to do with him.

So, at that point, in desperation, we, well, I called the psychiatrist

from the liaison team, who'd seen John at home and she was able to get involved

and really set things moving for us, so that was a huge help.

A typical day for me as, an older adult psychiatric liaison nurse would be

to go to the wards, following the referrals,

assess the patients, try to determine what is going on for them.

Is it a delirium? Is it a depression?

Do they have a dementia?

Suggest interventions, care plans or ways forward with the referring team.

I love my job. It's challenging.

It's exciting.

And I really can't understand why all trusts don't have a liaison service

because, you know, we're there for the patient.

I'm really, really passionate about liaison psychiatry services.

If you are looking at a person in a holistic way,

you are looking at their mental health needs as well as their physical needs.

And we know that any time in hospital for any of us can be scary.

But the liaison psychiatry is fantastic because it brings support,

expertise and education to staff

and to patients to ensure that their experience is... is a positive one.

It guides people through that journey.

TO LEARN MORE ABOUT US VISIT www.cnwl.nhs.uk/liaison-psychiatry

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