Understanding the scope of Consultation-Liaison Psychiatry referrals in a general hospital setting in New Zealand

BackgroundThe objective of this study was to characterise referrals to the consultation-liaison psychiatry (CLP) service at the largest district health board (DHB) in New Zealand. Materials and MethodsThis retrospective observational study analysed referrals (n=1046) received by the CLP service at Waitemat DHB in Auckland for those 18 years old over a period of six months (November 2017 to April 2018).Features of the referrals, assessments, and interventions from the emergency department (ED) and inpatient wards were analysed. ResultsThe main reasons for referral from the ED were self-harm/suicidal ideation and to a lesser extent, staff support.The main reasons for referral from the inpatient wards were mood disorder, medication management, and suicidal ideation.The main interventions by the CLP service were clarifying diagnoses, developing management plans based on risk assessments, medication advice, and seeking collateral information from other sources.Upon discharge from the CLP service, most referrals were passed on for mental health follow-up by other community mental health services. ConclusionsThe study demonstrates the diverse nature of referrals with the most common referral reason being mood disorder from inpatient wards versus self-harm from the ED.In line with this, the interventions most often offered by the CLP service in either setting were diagnostic clarification and risk assessment and management.This is the first detailed study of CLP referrals in a New Zealand setting.The results of this study provide insight into how CLP services function and recognise the complexity of services offered, and are relevant to services in Australasia and beyond.