Older Adults Mental Health Care Group, Michael Carlisle Centre, Nether Edge Hospital, 75 Osbourne Road, Sheffield S11 9BF, UK
Lloyd & Mayou (2003) argue cogently for the development of liaison psychiatry, or psychological medicine in general hospitals as they prefer it. Their arguments would carry more weight with commissioners if they included the mental health needs of older people. Two-thirds of general hospital beds are occupied by people aged over 65 and it is obvious to anyone visiting a general medical ward that the majority of bed-blocking is caused by older people with dementia, depression and prolonged delirium. The epidemiology, together with demonstrably poor coordination of services, is highlighted in a recent report, partly commissioned by the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists (Holmes et al, 2002).
The time is now ripe for old age psychiatrists to take their multi-disciplinary skills and experience of community support into general hospitals to enable earlier discharge of so-called bed blockers. Liaison psychiatrists could develop their services (and sub-speciality status) more quickly and comprehensively if they worked more closely with old age psychiatry colleagues clinically, and within the Royal College of Psychiatrists.
REFERENCES
Holmes, J., Bentley, K. & Cameron, I. (2002) Between Two Stools: Psychiatric Services for Older People in General Hospitals. Leeds: University of Leeds Academic Unit of Psychiatry and Behavioural Sciences.
Lloyd, G. G. & Mayou, R. A. (2003) Liaison
psychiatry or psychological medicine? British Journal of
Psychiatry, 183, 5
7.
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