Liaison psychiatry in rural general practice

The recent government health strategy document described the integration between primary and secondary care in Ireland as often poor and outlined plans to redress this deficit. In mental health ca re, the gradual shift away f rom institutions over the past four decades has resulted in the GP becoming the most frequent professional conta c t for people with mental disorders. However, access to specialist opinion is usually available only for the fraction of p s y chiatric pre s e n tations which are formally re f e r red to the psychiatric service. On-site psychiatric liaison to primary ca re is commonly practised in other countries but not in Ireland. Research in the area suggests possible advantages for appro a ch e s w h i ch aim to enhance GPs’ psychiatric skills while selectively encouraging referral of more serious disorders. This model has been adopted by GPs and psychiatrists in east Cavan and may be relevant to other similar settings, especially in the context of forthcoming changes in the organisation of primary care services.