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
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.
Most Liaison Psychiatrists
provide a service across three broad areas of the hospital:
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.
Liaison Psychiatry is a
sub-specialty of General Psychiatry.
Associated sub-specialties include:
- Perinatal psychiatry
- Academic psychiatry
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