Who Cares Wins - Royal College of Psychiatrists

6
Section III – Service Models
13. The report describes several models that can be adapted to provide liaison mental health services
for older people. They have advantages and disadvantages that need to be considered when
planning a local service.
14. No single model will meet all needs and a range of local factors will influence the choice of model
for a local service.
15. For a district general hospital the most appropriate model is the multidisciplinary liaison mental
health team and all services should plan this development. It is best placed to meet the needs of
older people and to deliver the core functions of a liaison mental health service particularly in
association with a shared care ward.
16. Whichever model is adopted it should fulfil the minimum requirements of a liaison service. These
include raising awareness of the importance of mental health, facilitating the acquisition of the basic
skills of mental health assessment and treatment by general hospital staff through education and
training, assisting with the management of serious and complicated cases of mental disorder and
championing the cause of older people with mental disorder in the general hospital.
17. The usual delivery of mental health assessment and advice for older people admitted to a general
hospital is the process of consultation, that is, case by case referral to the mental health
department. Consultation has several limitations including slow response, no capacity to develop
better standards of mental health practice in general hospitals and being essentially reactive.
18. In contrast, liaison mental health for working age adults is a developed speciality with at least 93
funded consultants in liaison psychiatry within the British Isles. These services have an established
multidisciplinary model of service delivery with recommended staffing levels and training
programmes.
19. The liaison approach is proactive, working collaboratively with general hospital departments and
providing a major focus on education and training to improve the mental health skills of general
hospital staff.
20. Liaison mental health services have been shown to offer several benefits in comparison with
consultation. Services offering only consultation should develop a liaison style of working.
21. Liaison services should be based in the general hospital and become integrated with general
hospital services in order that attention to the mental health aspects of clinical management become
part of routine general hospital care.
Section IV – Characteristics of a Liaison Mental Health Team
22. Liaison mental health is a specialised area of work and staff need proper induction, training and
clinical supervision. They must have dedicated time to fulfil their duties, adequate secretarial and
administration support and be managed as a specialist service.
23. Liaison services need adequate office space based in the general hospital and the necessary
resources to support their activity.