Abstract
AIMS AND METHODSTo devise a protocol, reflecting best practice, for obtaining second opinions in child and adolescent psychiatry through discussion with consultants in child and adolescent psychiatry within the Yorkshire region at their quarterly meetings.ResultsThe major pressure for second opinions falls upon the Academic Unit of Child and Adolescent Mental Health and on the in-patient units. Other consultants who are considered to have specialist expertise in certain areas may also receive referrals for second opinions. Both consultants requesting and offering second opinions considered a protocol for obtaining them would be helpful to their practice.Clinical ImplicationsAn agreed protocol between consultants in child and adolescent psychiatry within a region ensures that young people with complex problems have access to second opinions on their diagnosis and management by consultants who can be recommended to referrers by other consultants. The network of consultants ensures such opinions are not requested excessively and that ‘rogue’ opinions without therapeutic follow-up are avoided.
Highlights
The major pressure for second opinions falls upon the Academic Unit of Child and Adolescent Mental Health and on the in-patient units
Other consultants who are considered to have specialist expertise in certain areas may receive referrals for second opinions. Both consultants requesting and offering second opinions considered a protocol for obtaining them would be helpful to their practice
Second opinions are every person’s right, there are not the resources within the NHS to provide them on a large scale
Summary
Sir James Crichton-Browne was not prominently linked with the Colleges of Physicians, did not occupy a senior academic position, endowed no lectures or institutions, left no textbook of psychiatry and was ‘owned’ neither by England nor Scotland. In his very long life and career, there is conspicuous lineage between early asylum medicine and contemporary ideas of the cerebral basis of psychotic disorder. Renewed study of his life and many contributions, perhaps starting with his links to Charles Darwin and Hughlings Jackson would throw new light on the origins of evolutionary psychiatry
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