Abstract
Most psychiatrists who visit health centres use the shifted outpatient clinic model, the main aim of which is to improve secondary care by providing it in the primary care setting. For five years we have employed a liaison-attachment scheme in which support and advice from the psychiatrist enables general practitioners to improve their care of patients with psychiatric and psychological problems. One of the advantages of the latter model is that the psychiatrist can contribute to the care of patients not seen by the specialist psychiatric service and also to the development of the primary care team. The scheme is cost effective as psychiatrists can advise on the care of far more patients than they could see in formal referrals, fewer patients are taken on for a course of psychiatric treatment that could be provided by general practitioners and the skills of general practitioners and their trainees are enhanced. It is hoped that more general practitioners will adopt this pattern of working so that it can be fully developed and evaluated.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brown R. M., Strathdee G., Christie-Brown J. R., Robinson P. H. A comparison of referrals to primary-care and hospital out-patient clinics. Br J Psychiatry. 1988 Aug;153:168–173. doi: 10.1192/bjp.153.2.168. [DOI] [PubMed] [Google Scholar]
- Creed F., Anthony P., Godbert K., Huxley P. Treatment of severe psychiatric illness in a day hospital. Br J Psychiatry. 1989 Mar;154:341–347. doi: 10.1192/bjp.154.3.341. [DOI] [PubMed] [Google Scholar]
- Ferguson B. Current comment: (vii) Psychiatric clinics in general practice--an asset for primary care. Health Trends. 1987 Nov;19(4):22–22. [PubMed] [Google Scholar]
- Gask L. What happens when psychiatric out-patients are seen once only? Br J Psychiatry. 1986 Jun;148:663–666. doi: 10.1192/bjp.148.6.663. [DOI] [PubMed] [Google Scholar]
- Hansen V. Psychiatric service within primary care. Mode of organization and influence on admission-rates to a mental hospital. Acta Psychiatr Scand. 1987 Aug;76(2):121–128. doi: 10.1111/j.1600-0447.1987.tb02873.x. [DOI] [PubMed] [Google Scholar]
- Johnson D. A. A further study of psychiatric out-patient services in Manchester. An operational study of general practitioner and patient expectation. Br J Psychiatry. 1973 Aug;123(573):185–191. doi: 10.1192/bjp.123.2.185. [DOI] [PubMed] [Google Scholar]
- Johnson D. A. An analysis of out-patient services. Br J Psychiatry. 1973 Mar;122(568):301–306. doi: 10.1192/bjp.122.3.301. [DOI] [PubMed] [Google Scholar]
- Lesser A. L. Is training in psychiatry relevant for general practice? J R Coll Gen Pract. 1983 Oct;33(255):617–618. [PMC free article] [PubMed] [Google Scholar]
- Low C. B., Pullen I. Psychiatric clinics in different settings. A case register study. Br J Psychiatry. 1988 Aug;153:243–245. doi: 10.1192/bjp.153.2.243. [DOI] [PubMed] [Google Scholar]
- McKechnie A. A., Philip A. E., Ramage J. G. Psychiatric services in primary care: specialized or not? J R Coll Gen Pract. 1981 Oct;31(231):611–614. [PMC free article] [PubMed] [Google Scholar]
- Mitchell A. R. Liaison psychiatry in general practice. Br J Hosp Med. 1983 Aug;30(2):100-2, 106. [PubMed] [Google Scholar]
- Mitchell A. R. Psychiatrists in primary health care settings. Br J Psychiatry. 1985 Oct;147:371–379. doi: 10.1192/bjp.147.4.371. [DOI] [PubMed] [Google Scholar]
- Pullen I. M., Yellowless A. J. Is communication improving between general practitioners and psychiatrists? Br Med J (Clin Res Ed) 1985 Jan 5;290(6461):31–33. doi: 10.1136/bmj.290.6461.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strathdee G. Psychiatrists in primary care: the general practitioner viewpoint. Fam Pract. 1988 Jun;5(2):111–115. doi: 10.1093/fampra/5.2.111. [DOI] [PubMed] [Google Scholar]
- Strathdee G., Williams P. A survey of psychiatrists in primary care: the silent growth of a new service. J R Coll Gen Pract. 1984 Nov;34(268):615–618. [PMC free article] [PubMed] [Google Scholar]
- Tyrer P. Psychiatric clinics in general practice. An extension of community care. Br J Psychiatry. 1984 Jul;145:9–14. doi: 10.1192/bjp.145.1.9. [DOI] [PubMed] [Google Scholar]
- Tyrer P., Seivewright N., Wollerton S. General practice psychiatric clinics. Impact on psychiatric services. Br J Psychiatry. 1984 Jul;145:15–19. doi: 10.1192/bjp.145.1.15. [DOI] [PubMed] [Google Scholar]
- Whitehouse C. R. A survey of the management of psychosocial illness in general practice in Manchester. J R Coll Gen Pract. 1987 Mar;37(296):112–115. [PMC free article] [PubMed] [Google Scholar]
- Williams P., Clare A. Changing patterns of psychiatric care. Br Med J (Clin Res Ed) 1981 Jan 31;282(6261):375–377. doi: 10.1136/bmj.282.6261.375. [DOI] [PMC free article] [PubMed] [Google Scholar]