Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T09:57:00.548Z Has data issue: false hasContentIssue false

Developing an Integrated Mental Health Care Service: Description of a Pilot Mental Health Consultation/Liaison Clinic in a Primary Care Centre

Published online by Cambridge University Press:  13 June 2014

Nicolas Ramperti*
Affiliation:
Ballyfermot Primary Care and Mental Health Centre, Ballyfermot, Dublin 10
Daniel De La Harpe Golden
Affiliation:
Dept of Psychiatry, St Luke's Hospital, Freshford Road, Kilkenny
Iro Chinedu
Affiliation:
Cavan-Monaghan Mental Health Services
Seathrun O'Casaide
Affiliation:
Kilkenny Primary Care Centre, Ayrfield Medical Practice, Granges Road, Kilkenny
Frank Kelly
Affiliation:
Carlow/Kilkenny & South Tipperary Mental Health Services, St Luke's Regional Hospital, Freshford Road, Kilkenny
*
*Correspondence Email: [email protected]

Abstract

To determine if a consultation/liaison mental health clinic in primary care as proposed for Vision for Change, The Primary Care Strategy and the Department of Health is an efficient model of delivering mental health care in Ireland.

Methods: The pattern of service use and the clinical characteristics of new patients attending a pilot consultation/liaison clinic in a local primary care centre were studied.

Results: During the first 16 months of this clinic 1.2% of patients did not attend the initial assessment in the liaison clinic versus 29.75% in the regular Outpatients Department (OPD). Less than one in five (17.1%) required a follow-up review with the clinician in the consultation/liaison clinic compared to almost all patients first seen in OPD secondary care (96.6%). A small minority of patients (6.1%) needed referral to secondary care due to the complexity of their presentation.

Conclusions: A consultation/liaison mental health clinic in primary care results in an efficient use of manpower resources due to the low Did Not Attend (DNA) rates and low proportion of formal referrals to secondary care. As patients seem to favour this type of setting, over traditional outpatient departments, a move towards consultation/liaison clinics in the primary care team should be considered.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Tedstone Doherty, D, Kartalova-O'Doherty, Y, Walsh, D. HRB National Psychological Wellbeing and Distress Survey: Baseline Results: Health Research Board; 2007.Google Scholar
2.Copty, M, Whitford, L. D.Mental health in general practice: assessment of current state and future needs. Ir J Psych Med 2005; 22(3): 8386.CrossRefGoogle ScholarPubMed
3.Craven, MA, Bland, R. Shared mental health care: a bibliography and overview. Can J Psychiatry 2002;47:iS-viiiS, 1S103S.Google ScholarPubMed
4. Funk Dr Michelle. DGI. Integrating mental health into primary care: a global perspective.: World Health Organization and World Organization of Family Doctors, 2008.Google Scholar
5.Gask, L. et al.Evaluating models of working at the interface between mental health services and primary care. British Journal of Psychiatry 1997:611.CrossRefGoogle ScholarPubMed
6.Kierans, J, Byrne, M. A potential model for primary care mental health services in Ireland. Ir J Psych Med 2010;27:152–6.CrossRefGoogle ScholarPubMed
7.Wright, B. Integrating mental health and primary care services: a challenge for psychiatric training in Ireland. Ir J Psych Med 2007;24:71–4.CrossRefGoogle ScholarPubMed
8.Bower, P, Gilbody, S. Managing common mental health disorders in primary care: conceptual models and evidence base. Bmj 2005;330:839–42.CrossRefGoogle ScholarPubMed
9. Primary Care: A New Direction: Government of Ireland; 2001.Google Scholar
10. A Vision for Change: Report of the Expert Group on Mental Health Policy: Government of Ireland; 2006.Google Scholar
11.Pullen, IM, Yellowlees, AJ. Scottish psychiatrists in primary health-care settings. A silent majority. Br J Psychiatry 1988;153:663–6.CrossRefGoogle ScholarPubMed
12.Strathdee, G. Psychiatrists in primary care: the general practitioner viewpoint. Fam Pract 1988;5:111–5.CrossRefGoogle ScholarPubMed
13.Kates, N, Craven, MA, Crustolo, AM, Nikolaou, L, Allen, C, Farrar, S. Sharing care: the psychiatrist in the family physician's office. Can J Psychiatry 1997;42:960–5.CrossRefGoogle Scholar
14.Weingarten, M, Granek, M. Psychiatric liaison with a primary care clinic-- 14 years' experience. Isr J Psychiatry Relat Sci 1998;35:81–8.Google ScholarPubMed
15.Kitcheman CEA, J., Pervaiz, A., Kader, I., Mohandas, D. and Brookes, G.. Does an encouraging letter encourage attendance at psychiatric out-patient clinics? The Leeds PROMPTS randomized study. Psychological Medicine 2008;38:717–23.CrossRefGoogle Scholar
16.Dunne, E. The Views of Adult users of the public sector mental health services - Report of a surver for the mental health commission: Mental Health Commission; 2006 2006.CrossRefGoogle Scholar
17.Sims, H, Sanghara, H, Hayes, D, et al.Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatr Serv 2012;63:161–8.CrossRefGoogle Scholar