In the European study, liaison activities comprised only 5 per cent of all requests, and most CL work was through ad hoc consultations. Most of these requests were responded to on the same day. About half of these urgent requests by doctors and nurses concerned patients who had attempted suicide, surgical and trauma patients, and patients with a severe, usually organic, psychiatric disorder. CL services use a system-oriented approach, which recognizes the possibility of problems between the referring doctor and the referred patient.(18) Environmental factors should also be considered: the reason for and the effect of being in the hospital. A variety of services were offered, including diagnostic evaluation (13 per cent), prescription of medication (50 per cent), and the provision of behavioural guidelines for both ward staff (45 per cent) and families (15 per cent).(22) CL services appeared to have an important bridging function, facilitating transitions of care around admission and discharge. Thus, in about half of patients in the survey, other than the attempted suicide population, information was obtained from general practitioners, and in half information on discharge was provided to general practitioners. Of those discharged, 7.5 per cent were admitted to a psychiatric ward, and of those discharged to their homes 40 per cent were referred to outpatient mental health facilities. These figures were higher for the attempted suicide population. (22)
Assessment and treatment are considered in Chapter.5.6.
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