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Chris Hart discusses liaison psychiatry

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VOL: 98, ISSUE: 21, PAGE NO: 33

Chris Hart, mental health editor, Nursing Times

The interface between mental health liaison nurses and nurses in a general hospital is still in its infancy. Although mental health liaison nursing established itself as a specialty a few decades ago, many general nurses do not know what it involves.

The interface between mental health liaison nurses and nurses in a general hospital is still in its infancy. Although mental health liaison nursing established itself as a specialty a few decades ago, many general nurses do not know what it involves.

Given that 20-30% of patients will have significant psychiatric problems or physical disorders, a basic understanding of mental health problems is now essential for nurses on most wards and in A&E departments. About 5% of people attending A&E departments have purely psychiatric problems and deliberate self-harm is a common reason for young people to attend A&E departments (NHS Centre for Reviews and Dissemination, 1998).

Nurses from both backgrounds can work together in the interests of a patient group with complex needs. Liaison nurses are experienced in the management and care of people who present with challenging behaviours in the context of mental health problems.

It could be argued that they also use a wider variety of communication skills than general nurses, for example in defusing potentially problematic situations and creating opportunities for people to talk about their distress when the time and circumstances are appropriate. These skills can, and should, be passed on to colleagues whenever possible.

Mental health liaison nurses also work in A&E departments with people who present with mental health emergencies or deliberate self-harm. An essential part of their job is educating A&E staff on such presentations.

Research by Patrick Callaghan and his colleagues at City University (p34) examines a mental health liaison service at a London A&E department. It provides an insight into its benefits and the challenges facing it if improvements are to be made.

A key conclusion is that A&E, unsuited as it may be to host patients with mental health problems, is a key location for people making their first contact with mental health services. The importance of this area of mental health nursing cannot be overestimated and the researchers' discussion on the environmental and service needs should be considered by all policy-makers and managers.

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