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Higher training in liaison psychiatry for older adults: experiences of two specialist training posts

  • Maura Young (a1) and Siobhan Morris (a2)
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Over the past decade, old age liaison psychiatry services have been developing across the UK. The driving force behind this has been the recognition of the inequity in service provision for people over the age of 65 with mental health problems in a general hospital setting. A postal survey of consultants in old age psychiatry in April 2002 showed that most respondents (71%) considered that the service they provided to older people in general hospitals was poor and needed to be improved (Holmes et al, 2002). Much work has been done to highlight this issue, and liaison psychiatry for older adults is gaining prominence. The national conference on liaison psychiatry for older people, which has been held in Leeds for the past 4 years, attracts large numbers of enthusiastic participants. The Department of Health (2006) document A New Ambition for Old Age specifically mentions the current poor standard of care that older people with mental health problems receive in a general hospital setting. The Royal College of Psychiatrists (2005) has produced guidelines for the development of liaison mental health services for older people.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BRINDLE, N. & HOLMES, J. (2005) Capacity and coercion: dilemmas in the discharge of older people with dementia from general hospital settings. Age and Ageing, 34, 1620.
Department of Health (2006) A New Ambition for Old Age – Next Steps in Implementing the National Service Framework for Older People. Department of Health.
HOLMES, J., BENTLEY, K. & CAMERON, I. (2002) Between Two Stools: Psychiatric Services for Older People in General Hospitals. Report of a UK Survey. University of Leeds. http://www.leeds.ac.uk/lpop/documents/betweentwostools.pdf
MUJIC, F., HANLON, C., SULLIVAN, D., et al (2004) Comparison of liaison psychiatry service models for older patients. Psychiatric Bulletin, 28, 171173.
Royal College of Psychiatrists (2005) Who Cares Wins. Improving the Outcome for Older People Admitted to the General Hospital. Royal College of Psychiatrists.
Royal College of Psychiatrists (2006) The Dean's Medical Education Newsletter. http://www.rcpsych.ac.uk/pdf/Newsletter%20July%20August%202006%20(2).pdf
STEWART, R., BARTLETT, P. & HARWOOD, R. (2005) Mental capacity assessments and discharge decisions. Age and Ageing, 34, 549550.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Higher training in liaison psychiatry for older adults: experiences of two specialist training posts

  • Maura Young (a1) and Siobhan Morris (a2)
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eLetters

Liaison in Old Age Psychiatry

Vishal Agrawal, SpR in Psychiatry
25 September 2007

Drs. Young and Morris have described an experience that increasing number of higher specialist trainees are now able to access. This has to be positive thing both from liaison and old age psychiatry point of view.

I had a chance to work in a predominantly old age psychiatry liaison post as SpR a few years ago. This was at Homerton Hospital in East London and City Mental Health Trust. I did four sessions in liaison with other two being with another old age consultant doing community and inpatient work. This was mainly because the intensity did not require six sessions of SpR time and also traditionally my predecessors had wanted other experience also.

The limitations of my post were that besides me, the only other members of my team were my educational supervisor and SHO attached to the post. There was no input from a multidisciplinary team. In spite of this, we had very effective communication with the elderly care physicians and did manage quite effectively most of the time. I share with the authors myfeeling that I felt my skills of communication and management planning improved substantially during my placement.

We also did a comparative study of referrals to this service as compared to the traditional old age service (combination of inpatient, community and liaison work). Both these were within the same Trust but in separate geographical areas. The main points highlighted in this study were that pattern of referrals was generally the same in both sectors withsimilar outcomes. In dedicated liaison psychiatry service, assessments were completed earlier and the assessment letters typed and sent quicker. Also, there was better organization with single point of contact with morelegible, detailed assessments. However none of the teams assessed patientsin a multidisciplinary format on a regular basis.

As clinicians gain more experience, hopefully some benchmarking of standards in old age psychiatry will be achieved to enhance service organization and delivery

Declaration of Interest: None
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Conflict of interest: None Declared

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