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Liaison Psychiatry

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Nature of the work

Liaison Psychiatry is a young and developing sub-specialty.

Liaison Psychiatry teams provide the psychiatric service for general or acute hospitals (and occasionally other types of hospital).  We work at the interface of physical health and mental health.  Liaison Psychiatrists are often treating people who are severely unwell, and have to balance people’s need for psychiatric treatment against their need for physical treatment.

Most Liaison Psychiatrists treat ‘working age adults’ (18-65yrs) and many also see and treat older adults.  Increasingly some new consultant posts have been developed for specialist Older Adult Liaison Psychiatrists, and there are a very small number of specialist Child and Adolescent Liaison Psychiatrist posts.

Liaison Psychiatry is sometimes known as Psychological Medicine or Consultation-Liaison Psychiatry.

Working in Liaison Psychiatry

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

You will need to feel confident assessing people across the whole range of psychiatric diagnoses, and until you arrive at work in the morning you won’t know which patients (with which diagnoses) are going to be referred to you.  This makes the work interesting, varied and challenging.

Compared to other psychiatric sub-specialties, in Liaison Psychiatry there is a relatively greater emphasis on assessment, and less emphasis on providing ongoing treatment.  If you like a diagnostic challenge, you like working in a hospital, and you enjoy the more acute aspects of psychiatric practice, then Liaison Psychiatry may be a career for you.

Common procedures/interventions

Most Liaison Psychiatrists provide a service across three broad areas of the hospital:

  •     The Emergency Department
  •     Hospital wards
  •     Liaison Psychiatry outpatient clinics

In the Emergency Department we work closely with Emergency Medicine consultants and other clinicians to assess and treat people who have presented acutely with psychiatric disorders.  This ranges from acute psychoses to deliberate self-harm and drug & alcohol disorders, and undiagnosed patients who appear to be suffering from an acute mental disorder.  Calmness, efficiency and decision-making are key attributes here.

On the hospital wards we treat a wide range of psychiatric disorders, some of which may have arisen as a result of a physical health problem.  In other cases the psychiatric disorder may have led to the health problem, or the two problems may be coincidental.  Most Liaison Psychiatrists will treat some older adults, where skills in assessing and managing confusional states and dementia are also important, as well as finding the right treatment for someone who may have multiple physical health problems and may be taking an array of medication.  We need to consider the person’s home setting, safety and independence as well as making decisions about medication and follow-up.

The Liaison Psychiatry outpatient clinic reflects the patient group served by the hospital.  Liaison Psychiatrists usually offer treatment for patients with medically unexplained symptoms, as well as common mental disorders (anxiety and depression) that may arise from or worsen a person’s physical symptoms.

Associated subspecialties

Liaison Psychiatry is a sub-specialty of General Psychiatry.

Associated sub-specialties include:

  • Neuropsychiatry
  • Perinatal psychiatry
  • Academic psychiatry

 

Further information

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