The Case of Need for OPMH Liaison Services. John Holmes Senior Lecturer in Liaison Psychiatry of Old Age University of Leeds. To establish a convincing case of need:. Evidence that mental health problems in older people are common in general hospitals
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Senior Lecturer in Liaison Psychiatry of Old Age
University of Leeds
110 of the 5038 attendances (2.2%) were by older people
(Nightingale et al 2001, Lancet, vol. 357, no. 9264, 1264-126)
(Holmes& House 2000, Psychol Med vol. 30, 921-929)
Physical care needs are prioritised over mental health needs
Nurses perceive themselves and medical staff as lacking the skills needed to recognise and manage mental health difficulties
General nurses believe older people with mental health difficulties do not get a good service in general hospitals.
“In terms of managing somebody’s mental illness, we are doing them a disservice, and if it was a medical problem, you know, it wouldn’t be tolerated, but because it’s a mental health problem it is.”
“And the patients that are confused do get neglected, because you don’t give them the attention that you could give if you didn’t have your acutely unwell.”
“Like taking sticks off people, and moving the table away so they can’t even get their water; cos they throw it.”
Atkin et al. Int J Geriatr Psychiatry 2005; 20(11):1081-3.
“How to engender some knowledge for the management of psychiatry disorders in non psychiatry areas”
“Your questionnaire makes me aware of… …how much mental disorder/psychopathology/unhappiness and distress is being missed or probably dealt with inappropriately”
“The general attitude is that anyone with a psychiatric label should be put in a corner and ignored - almost universal on surgical and orthopaedic wards”
“Few referrals from surgery. I dread to think that they just over-sedate delirious patients with loads of haloperidol.”
Some solutions identified: