TY - JOUR
KW - Adult
KW - Female
KW - Humans
KW - Male
KW - Mental Disorders/therapy
KW - Mental Health Services/manpower
KW - Primary Health Care
KW - Psychiatry/methods
KW - Referral and Consultation
AU - J. S. Emmanuel
AU - A. McGee
AU - O. C. Ukoumunne
AU - P. Tyrer
A1 - 
AB - BACKGROUND: Despite much interest in the development of liaison psychiatry in general practice there is no clear evidence that any form of intervention is effective. We carried out a pilot randomised controlled trial, the first we believe into this type of care, of one such model; enhanced liaison with individual patients by key workers, in general practices in Paddington and North Kensington in London. METHODS: All patients referred from primary to secondary psychiatric care from four general practices over a 10-month period, and still in contact with services, were eligible to be included in the study. The practices were allocated in a constrained randomised procedure to either normal care or enhanced key-worker liaison. The latter involved encouraging individual key workers to adopt improved communication between primary and secondary care. Baseline assessments of symptomatology and social functioning were made before randomisation and after 6 months by an independent researcher. RESULTS: Of the 84 eligible patients, 43 were seen at baseline and 34 re-assessed after 6 months. There was no difference between the clinical outcomes in the two groups but self-rated social function was significantly improved in the enhanced liaison service compared with standard care (adjusted P = 0.05). Costs were similar but somewhat more expensive for enhanced liaison. Less than half (42 %) of all key workers in the enhanced liaison arm felt they had involved the primary health care team more in the care of their patient, with 21 % of these altering their practice markedly during the study. CONCLUSIONS: It is concluded that without additional resources enhanced key-worker liaison for psychiatry in primary and secondary care has limited benefits although this does not necessarily apply to other forms of liaison practice.
BT - Social psychiatry and psychiatric epidemiology
C5 - Education & Workforce
CP - 6
CY - Germany
DO - 10.1007/s00127-002-0550-y
IS - 6
JF - Social psychiatry and psychiatric epidemiology
N2 - BACKGROUND: Despite much interest in the development of liaison psychiatry in general practice there is no clear evidence that any form of intervention is effective. We carried out a pilot randomised controlled trial, the first we believe into this type of care, of one such model; enhanced liaison with individual patients by key workers, in general practices in Paddington and North Kensington in London. METHODS: All patients referred from primary to secondary psychiatric care from four general practices over a 10-month period, and still in contact with services, were eligible to be included in the study. The practices were allocated in a constrained randomised procedure to either normal care or enhanced key-worker liaison. The latter involved encouraging individual key workers to adopt improved communication between primary and secondary care. Baseline assessments of symptomatology and social functioning were made before randomisation and after 6 months by an independent researcher. RESULTS: Of the 84 eligible patients, 43 were seen at baseline and 34 re-assessed after 6 months. There was no difference between the clinical outcomes in the two groups but self-rated social function was significantly improved in the enhanced liaison service compared with standard care (adjusted P = 0.05). Costs were similar but somewhat more expensive for enhanced liaison. Less than half (42 %) of all key workers in the enhanced liaison arm felt they had involved the primary health care team more in the care of their patient, with 21 % of these altering their practice markedly during the study. CONCLUSIONS: It is concluded that without additional resources enhanced key-worker liaison for psychiatry in primary and secondary care has limited benefits although this does not necessarily apply to other forms of liaison practice.
PP - Germany
PY - 2002
SN - 0933-7954; 0933-7954
SP - 261
EP - 266
EP - 
T1 - A randomised controlled trial of enhanced key-worker liaison psychiatry in general practice
T2 - Social psychiatry and psychiatric epidemiology
TI - A randomised controlled trial of enhanced key-worker liaison psychiatry in general practice
U1 - Education & Workforce
U2 - 12111030
U3 - 10.1007/s00127-002-0550-y
VL - 37
VO - 0933-7954; 0933-7954
Y1 - 2002
ER -