Liaison psychiatry

Liaison psychiatry is a sub-specialty of general psychiatry. Liaison psychiatrists provide psychiatric care to medical patients. These include those attending emergency departments, general hospital in and out patients, and increasingly patients being seen in community and primary care medical services.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Liaison psychiatry is sometimes known as consultation-liaison psychiatry and increasingly as psychological medicine. It's a young and rapidly growing psychiatric sub-specialty.

Liaison psychiatrists work with physically ill people and with the staff who care for them. This poses special challenges and requires expertise in managing multi-morbidity and in working with clinical staff in other specialties.

Most liaison psychiatrists treat ‘working age adults’ (aged 18 to 65) although there are also old age liaison posts. Increasingly however services are providing an ‘ageless service’ that sees all adults whatever their age. There are also a small but increasing number of specialist child and adolescent posts. A significant part of the work of a liaison psychiatry service will be to provide teaching and training, both formal and informal, to general hospital colleagues on the recognition and basic management of mental health problems that arise in the hospital setting.

If you specialise in liaison psychiatry, you are likely to be based in a general or acute hospital, rather than in a psychiatric hospital.

If you like to use you hard earned medical knowledge and skills and also like working in a general hospital setting, then liaison psychiatry may be a career for you.

“I treat patients with delirium, dementia and severe depression. They often have multiple and severe physical and mental health problems”. Jude Harrison, Clinical Academic Training Fellow in Psychiatry based in Wales

Read Jude’s story

Common procedures/interventions

Most liaison psychiatrists provide a service across three broad areas of the hospital:

In the emergency department, liaison psychiatrists work closely with emergency medicine consultants and other clinicians to assess and treat people who have presented with psychiatric disorders. These range from acute psychosis to self-harm and drug and alcohol related problems. There is an increasing emphasis on the combined medical and psychiatric management of frequently attending patients with complex multi-morbidity.

On the hospital wards liaison psychiatrists see patients with a wide range of psychiatric disorders. They may provide individual assessment and treatment or may advise medical and nursing staff on how to manage the patient. Most liaison psychiatrists will treat some older adults, where skills in assessing and managing confusional states and dementia are also important.

They also establish the right treatment for someone who may have multiple health problems and may be taking several medications. The person’s home setting, safety and independence must all be considered as well as decisions about medication and follow-up.

Increasingly liaison psychiatrists see patients in outpatient and community settings, either in dedicated clinics or in conjunction with other specialists in their clinics. They also work in primary care.

Liaison psychiatrists must be ready to offer assessment and treatment to people with any psychiatric disorder.  Commonly encountered problems and disorders are self-harm, delirium, depression, anxiety, acute psychosis, addictions and dementia.  They also see people with medically unexplained symptoms, neuropsychiatric disorders, perinatal mental health problems, eating disorders and almost any other psychiatric disorder.

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