Abstract
A large number of people admitted to medical wards have co-morbid mental health problems, and these predominantly include depression, dementia and delirium. An additional one third of medically ill patients remain in hospitals with undetected and, therefore, undiagnosed mental health problems. The comorbidity of mental and physical illnesses leads to poor health outcomes, prolonged inpatient stays and use of inpatient resources, involvement of various affiliated health services, introduction of medications and discharge to long-term facilities, including residential and nursing 24-h care, increased both readmission rates and mortality. The establishment of Liaison psychiatry services to meet the needs for people with mental health problems admitted to medical wards is a priority for many acute health Trusts. This has an economical background in terms of cost-savings, especially in relation to the older adults, with decreasing readmission rates and quicker hospital discharges. In the current review, we address the latest policies regarding Liaison psychiatry services; especially those for older people with dementia and delirium, and discuss their future shaping.
Highlights
A large number of people admitted to medical wards have co-morbid mental health problems.These predominantly include depression [1,2,3], organic mental health problems, such as dementia [4,5]and delirium [6,7]
Since mental health problems co-exist with a number of chronic and acute health conditions it is not surprising that mental health co-morbidities contribute to a substantial increase in physical health care, amounting up to £12.5 billion/year extra expenditure on physical health services [17,18]
The investment in development of new and expansion of currently available Liaison psychiatry services is seen as a must in the National Health Service (NHS) development [27]
Summary
A large number of people admitted to medical wards have co-morbid mental health problems. The comorbidity of mental and physical illnesses leads to poor health outcomes in terms of prolong inpatient stays, longer use of inpatient resources, e.g., rehabilitation, involvement of various affiliated health services, medication, discharge in long-term facilities, including residential and nursing 24-h care [11,12], and increased mortality [13,14,15]. Not surprisingly, the latter findings result in increased health care costs [16]. That are confined to the inpatient stay, and to the increase in outpatient attendance [17,18]
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