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Providing a primary care service for psychiatric in-patients

  • Enone Welthagen (a1), Sarah Talbot (a2), Oliver Harrison (a3) and Michael Phelan (a4)
Abstract
Aims and Method

A prospective descriptive study was set up to evaluate the feasibility, acceptability and activity of an innovative weekly primary care service for patients admitted for acute psychiatric care.

Results

During 10 months, 36 clinics were held and 123 appointments were attended. Presenting complaints included a wide range of acute and chronic conditions, affecting all body systems. As well as treating specific complaints, the doctor providing this service undertook considerable health promotion work and gave advice about patient management to junior psychiatrists.

Clinical Implications

It appears that there is considerable need for primary care expertise within an acute psychiatric unit, and that a weekly clinic is a feasible model of care.

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Copyright
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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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Providing a primary care service for psychiatric in-patients

  • Enone Welthagen (a1), Sarah Talbot (a2), Oliver Harrison (a3) and Michael Phelan (a4)
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eLetters

Primary Care for Psychiatric In-patients

Laura J Fisher, Research Officer
22 July 2004

The article by Welthagen et al (2004) regarding the provision of a primary care service for psychiatric in-patients was a useful reminder of the importance of addressing physical issues in persons with mental disorders. In Australia this has been addressed by the Australian Councilof Health Care Standards (ACHS), in conjunction with the Royal Australian and New Zealand College of Psychiatrists, who have developed a number of clinical indicators for use in psychiatric Hospitals (ACHS, 2003). These include the assessment of whether or not a patient has had a physical examination within 48 hours of admission.

At The Adelaide Clinic, a 64 bed private psychiatric hospital, a nearby group of general practitioners provides a five days a week primary care service at the hospital. In 1997-98 there was compliance with the Clinical Indicator for physical examination within 48 hours of admission in 80% of admissions (Goldney et al, 1998), and this has risen over the last year to 95%. The ACHS provides data for 63 hospitals (both public and private) Australia-wide and the current overall compliance figure for this clinical indicator is 84%.

We note that the service reported by Welthagen et al provided assessment of 22% of patients after a median time of 22 days. Although their service is a step in the right direction, we believe it falls far short of an ideal assessment of the physical status of those with mental disorders.

AUSTRALIAN COUNCIL OF HEALTHCARE STANDARDS (2003) Clinical IndicatorUsers’ Manual 2004: Mental Health Indicators Version 4. Sydney: ACHS.

GOLDNEY, R., FISHER, L., WALMSLEY, S. (1998) Quality improvement byuse of Clinical Indicators in a psychiatric hospital. Australasian Psychiatry, 6, 191-193.

WELTHAGEN E., TALBERT S., HARRISON O., PHELAN M. (2004) Providinga Primary Care Service for Psychiatric In-patients. Psychiatric Bulletin,28, 167-170.

*Laura Fisher, Research Officer, The Adelaide Clinic, Ramsay Health Care Mental Health Services South Australia, 33 Park Tce, Gilberton, SouthAustralia, 5081.

Robert Goldney, Professor, The University of Adelaide, Psychiatry Department, The Adelaide Clinic, 33 Park Tce, Gilberton, South Australia, 5081.
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Conflict of interest: None Declared

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