The Royal College of Psychiatrists has released guidance for Commissioners of Mental Health Liaison Services in Acute Care. The guidance document is one of a suite of four documents for commissioners covering all aspects of mental health commissioning.
There is a strong connection with substance use and mental health issues. The Institute of Alcohol Studies reports that up to 6% of patients with two or more neurotic disorders are alcohol dependent, as opposed to 2% of the general population.
Frequently alcohol is implicated in self-harm, whether as a substance of regular misuse or as an agent for the self harm. A briefing paper by Alcohol Concern echoes the links between alcohol use and mental health co-morbidity, stating that alcohol is a significant factor in suicides, with up to 65% involving alcohol misuse. With the advent of community care, people with severe mental health problems are more likely to be living in the community and exposed to easy access to alcohol.
Identifying and supporting people with mental health and alcohol problems as they enter Acute Care is a challenge. The new guidance showcases the Birmingham Rapid Assessment Interface and Discharge (RAID) model as good practice. The RAID service offers consultant and liaison support to A&E, MAU, Medical, Maternity and Surgical wards. It offers a holistic approach which addresses the patient's mental health, physical health and social needs. This inclused assessment and support for addictions and an important "all age appropriate" service.
The guidance calls for the better assessment, management and signposting of mental health issues, including alcohol-related problems. The benefits of better liaison services would include: reduced Out Patient attendances, reduced hospital admissions and re-admissions and better protection of patients from avoidable harms. Both alcohol and mental health problems carry huge stigma, and it is hoped that by following a holistic approach to patient care this could be significantly reduced.
The guidance documents are launched a year after the DH released No Health without Mental Health, the cross government mental health outcomes strategy.