The paper reviewed here is a 2007 Australian paper ‘The Consultation-Liaison in Primary Care Psychiatry Program: A Structured Approach to Long-Term Collaboration’ by Meadows and colleagues and freely available here.
The authors in this paper describe a model for a psychiatric service providing input to primary care. This is the Consultation-Liaison in Primary Care Psychiatry (CLIPP) Model. The service is specific to Australia given the structure of Australian health services. They describe the following components of the CLIPP Model
- Consultation Liaison and Education half-day sessions at the General Practice groups by a visiting psychiatrist with an option to provide specialist support if necessary reimbursed through a benefit scheme.
- Collaborative care with the private sector
- Supervisory input by psychiatrists and community psychiatric nurses in collaboration with the GP.
Regarding the first component, consultation-liaison services providing input to hospital services have been described elsewhere. Here the consultation-liaison service is being applied to a service delivered to primary care. This service has many analogies to a community outpatient clinic also. The collaboration with the private sector in the second part of the model has possibly been an adaptation to available resources and the authors describe this service as particularly useful in relapse prevention. In the supervisory component the service includes a reminder system to alert the psychiatrist when the next visit is due. There is also an option for a visit by a community psychiatric nurse if necessary. The researchers followed up a group of 62 patients transferred to the service. In the first 12 months of the transfer there was a small drop in functioning but the functioning was maintained from 12 to 24 months.
The service perhaps suited the needs of the local health services in Australia. Health services in other countries have different needs and resources and developments in one country may be applicable to some countries and not others depending on the relevant service configurations and resources. The authors utilise a method of evaluating services in transition. Also the use of a reminder system for community work may be analogous to the clinic booking system although it could be usefully applied to other community services.
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