People are hospitalized for many reasons, including trauma, heart attacks, and stroke. Perhaps, a person needs intensive treatment for cancer or elective surgery to replace a hip or a knee. Regardless of the reason for hospitalization, it is not unusual for the medical or surgical doctor to request a psychiatric consultation. Why? Many medical conditions and/or the treatments used for these conditions are associated with behavioral symptoms, and the internist or surgeon often wants input from a psychiatrist to help determine the cause of the behavioral changes and identify effective treatments.

Behavioral or mental health conditions are closely linked to acute or chronic illnesses and hospitalization. Approximately 30% of all patients’ in general medical / Surgical hospital settings exhibit psychiatric disorders, with delirium being detected in 10% of all medical inpatients and 30% in certain high-risk patient groups. An alarming two-thirds of high-frequency users of medical services have a psychiatric disorder, most commonly depression (23%), anxiety (22%), and somatic symptom disorder (formerly somatization disorder) (20%).As one would anticipate, the high psychiatric comorbidity to other medical disorders in hospitalized patients significantly increases their length of hospital stay. Lastly, psychiatric comorbidity remains vastly under recognized and undertreated in these hospitalized patients.

Consultation & Liaison psychiatry is a sub-specialty of psychiatry in which a consultation service is offered to patients admitted to a general medical-surgical hospitals.

The purpose of this service is to “provide the psychiatric care of patients with complex medical, surgical, obstetrical, and neurological conditions” and to improve the overall outcome of hospitalized patients.

Referrals are made when the treating medical team has questions about a patient’s mental health, or how that patient’s mental health is affecting his or her care and treatment. Typical issues include:

  • Patients with medical conditions that cause/exacerbate psychiatric or behavioral problems, such as delirium.
  • Supporting the management of patients with mental disorders who have been admitted for the treatment of medical problems.
  • Assisting with assessment of the capacity of a patient to consent to treatment.
  • Patients who may report physical symptoms as a result of a mental disorder, or patients with medically unexplained physical symptoms.
  • Patients who may not have a psychiatric disorder but are experiencing distress related to their medical problems.
  • Patients who have attempted suicideor self-harm.
  • Assisting with the diagnosis, treatment and functional assessment of people with dementia, including advice on discharge planning or the need for long-term care.