The referred population

Most patients with psychiatric disorders or vulnerabilities are treated by non-mental-health professionals and only a few (1-2 per cent of admitted patients) are seen by psychiatric consultants/1,2,17 Conflicts between staff and patients are among the reasons for referral in about 20 per cent of the consultations. (!8.) CL psychiatric services can be described as responding to the needs of doctors and nurses.

In 1991, the European Consultation-Liaison Workgroup for General Hospital Psychiatry and Psychosomatics assessed the extent and content of CL service delivery to 14 Z1Z inpatients seen by consultants from 56 CL psychiatric services in 11 European countries. (19,,2°,21,2 and 23) The most striking finding was the large variation between the target populations and the number of patients seen. The large size of this collaborative study made it possible to use statistical techniques to best describe the referred patients. Two important groups of patients were identified as separate from the remaining population: those referred for attempted suicide and for substance abuse. On average, these groups made up between a quarter to a third of those referred. The remaining patients can be distinguished using six clinical characteristics: two sociodemographic features (age and sex), two describing the preadmission status of the patients (the presence of chronic physical disease or use of services, and the presence of a mental disorder and the use of mental health services), and two relating to patient status at referral (the severity of their psychopathology and the clarity of physical diagnostic characteristics).

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