Liaison and psychiatricmedical function

In the consultation function psychiatrists wait to be asked for their opinion. However, the liaison function is more proactive and preventive, in that the consultant tries to establish a stable relationship with a department which sees a high prevalence of patients with psychiatric problems. This is effected through weekly staff meetings and often by additional staff training. The 'psychiatric-medical function' is an integrated service aimed at meeting the structural and organizational requirements of the target population. This is guided by nurse acuity levels. Staff are selected and trained to provide integrated care. Organizational prototypes of this function are the psychological-medicine units and the German psychosomatic wards.(!) Specific target populations include behaviourally disturbed patients, who are physically unwell and require complex medical care, complex somatizers, those with chronic pain, and specific patient populations from, for example, neurology or geriatric wards. Using this approach, care needs may be assessed at admission. Moreover, the development of guidelines may be prepared for ward staff, for example in relation to substance abuse and confusion in the elderly.(2)

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