Liaison Psychiatry: A Role on the Medical Intensive Care Unit

Abstract

A psychiatric liaison program on a medical intensive care unit is described. The principle elements of the program include the psychiatrist becoming a member of the MICU "team" via: 1) attendance at morning medical rounds; 2) conducting case conferences; 3) availability to the nursing staff as a separate entity; 4) consulting with the unit directors; and 5 ) supervising a resident in psychiatry in his consultative work on the unit. The liaison psychiatrist's presence on the team facilitates an holistic approach to the patient and deals with intra-staff and patient-staff reactions in the critical care setting.Liaison psychiatry, in the past ten years, has assumed an increasingly important role in promoting an holistic approach to the patient. The liaison psychiatrist attempts to bridge the gap between mind and body, viewing the medically or surgically ill patient as needing attention for his physical problems as well as hs psychological reactions to those difficulties. Furthermore, he is sensitive to the interplay between staff and patient and the impact of that interaction on patient care.We have had an experience, over the past two years, in which a psychiatrist has been integrated into the treatment team of a medical intensive care unit in a large university hospital. This article will describe our experience and present a model for the psychiatrist's role on the MICU team as clinician, teacher, and consultant. Our model demonstrates a balance between liaison and consultative

A liaison psychiatrist attached to an intensive care unit: Why such a rare creature?

“…Carmelle Peisah 1,2,3 and Dani Goh 3 To the Editor Billig (1982) described the role of a liaison psychiatrist integrated in an intensive care unit (ICU) in Georgetown, United States, as psychopharmacological consultant, patient ombudsman, staff support consultant and teacher.…”

“…Since Billig (1982) one study compared the latter conventional C-L model with a psychiatrist embedded in daily ICU rounds (Bui et al, 2019). For the intervention (embedded) group, consultation rates were higher (p < 0.001) and time to psychiatric consultation shorter (3.19 days embedded group; 7.48 days controls; p = 0.004).…”

“…In April 2019, a liaison psychiatrist employed 0.4 Full Time was appointed to our 46-bed ICU, employed by the ICU, embedded within ward rounds and working inside the unit during working hours. The role, dynamic and responsive to service needs, has evolved to that described by Billig (1982) that is, as clinician, staff support/ welfare psychiatrist and teacher. With regard to the clinical role, we describe 50 consecutive referrals between April 2019 and January 2020 (Table 1).…”

Avaliação das reações dos pais à internação do filho em unidade de terapia intensiva e desenvolvimento de uma proposta de apoio psicológico

“…Outros autores propõem algumas estratégias para o atendimento aos pais, como: a) aumento nas horas de visita (BARNETT et al, 1970;MINDE et al, 1978;STILLWELL, 1984); b) participação nos cuidados de enfermagem (JAY, 1977); c) integração com outros profissionais, como psicólogos e psiquiatras (BILLIG, 1981); assistentes sociais (FOSTER, 1980;KORNBLUM;MARSHALL, 1981), estudantes e voluntários da comunidade (HODOVANIC et al, 1984). MILES et al (1993) A organização de grupos de pais em UTI baseia-se nos bons resultados obtidos com grupos de pais de crianças de outras clínicas, por exemplo, leucêmicos e diabéticos (RANÑA, 1987).…”

“…As famílias esperam que os médicos dêem informações e ofereçam métodos para lidar com a doença e suas conseqüências, porque precisam desse tipo de apoio (RUKHOLM et al, 1991 (BILLIG, 1981;ZEANAH;JONES, 1982;AISENSTEIN, 1987).…”