Abstract
General hospital psychiatry operates between the somatic and
psychiatric approaches concerning the treatment of patients, combining
knowledge from both somatic and psychiatric medicine. To establish
its position, the general hospital psychiatry has to specify its
role and means when rendering services.
This study revealed how consultation had been arranged in
six Finnish polyclinics of general hospitals. The goal was to find
out which types of patients were referred to the consultation of
the general hospital psychiatry and the extent of collaboration
of the consulting psychiatrist with colleagues from other medical
disciplines. Moreover, the focus of attention was on whether there were
operational differences between the polyclinics of the University
Hospital of Oulu and other hospitals. The work was also addressed
to probing operational differences, if any, pertaining to people under
or over 65. Additionally, one aspect to be clarified was how requests
for psychogeriatric consultations and the responses of the consulting
psychiatrists had developed during the five years period of the
study.
This study was part of a broad European Consultation Liaison
Working Group effort aimed at clarifying the organization of general
hospital psychiatry in 56 units in 11 European countries. The Finnish
material consisted of 1255 patients, of whom 202 were over 65. The
research methods applied here were psychiatric interviewing of clinical
patients, and filling in of data collection forms following the
instructions of the ECLW Group.
The current work revealed that the number of psychiatric consultations
was less than expected considering the incidence of psychiatric
symptoms among somatically ill patients. Of the general hospital
patients, elderly people were especially underrepresented. More
than 90% of the patients who had a psychiatric consultation
were diagnosed with a psychiatric problem. Thus the general hospital
made available psychiatric treatment via psychiatric consultation,
with a recommendation for future psychiatric care for more than
half of the patients. However, one third of the patients under 65 and
quarter of those above that age had already had on going psychiatric
treatment. In view of this type of situation the position of the
general hospital appears problematic. The object of consultation was
in 90% of the cases the patients themselves, but in Oulu,
almost half of the consultations were due to the personnel of the
somatic disciplines in charge of the of the patients. The action
mode in separate general hospitals was connected to established
traditions, although the history of general hospital psychiatry
is short and faces constraints put forward by the somatic hospitals.
Collaboration between psychiatric and somatic disciplines was facing
increasing difficulties during the five years observation period,
probably due to economic recession.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-5466-X |
| Date | 24 November 1999 |
| Creators | Hiltunen, P. (Pirkko) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | Finnish |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 1999 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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