Needs for psychiatry in the general hospital

Thirty to 60 per cent of the patients in general hospitals suffer from significant psychological dysfunction or psychological dysfunction secondary to their medical illness. In addition to helping medically ill patients adapt to their illness and hospitalization, psychiatrists who work in general hospitals should develop the biopsychosocial model of diagnosis and management and improve the staff's capacity to detect, diagnose, and manage their patients' psychological problems. The author discusses specific needs for consultation-liaison psychiatry in the general hospital such as development of prevention schema, case detection, continuing education programs for staff, and education groups for patients and families. He also describes structural innovations to meet the increasing demands for psychiatric services in the general hospital setting. These innovations include the establishment of a biopsychosocial database system and the use of screening devices, medical-psychiatric inpatients units, and medical-psychiatric aftercare clinics in ambulatory facilities.