Changes to inpatient consultation-liaison psychiatry service delivery over a 7-year period

Objective: The aim of this paper was to examine the effect of changes to a consultation-liaison (C-L) service at Maroondah Hospital on referral and service delivery patterns across a period of 7 years. There is no national benchmarking of C-L service. Local services respond to local political and service demands. There have been significant changes to the C-L service at Maroondah Hospital between 1999 and 2006. During the intervening years, psychogeriatric referrals have been included and gazetting of general hospital beds has resulted in detention of patients under the Mental Health Act (MHA). Method: Clinical audit data from assessments by the C-L service during the above period were entered into a database and analysed. Results: The annual referral rate increased as did the mean age of referred patients. The main reason for referral changed from suicide evaluation and history of psychotic symptoms to depression. Referral lag time did not change significantly. A higher proportion of patients received a single consultation and a greater number required psychiatric inpatient care. Conclusion: The nature of referral changed towards older, sicker patients and away from younger, suicidal patients which, together with an increased referral rate, significantly increased demand on available resources.