The Psychiatrist as Consultant: Working Within Schools, the Courts, and Primary Care to Promote Children's Mental Health

This article presents a broad description of psychiatric consultation to schools to introduce concepts relevant in all child and adolescent psychiatric consultation outside of the hospital setting. A model of the consultation process is presented, which includes: (1) the consultant's entry into the system that is requesting consultation, (2) the process of defining the question posed, (3) identification of the focus of consultation and the consultant's role, and (4) measuring outcomes. Cases from psychiatric consultation to schools, juvenile justice, and primary care illustrate the various roles that a consultant may fill in providing consultative services for children and adolescents. Current trends in psychiatric consultation are described, including a shift away from indirect consultation and toward a collaborative role.