6 Brain injury rehabilitation: audit of a neuropsychiatry liaison service

Objective Since 2013, rehabilitation after brain injury has been coordinated in Cheshire and Merseyside through a rehabilitation network. The network consists of four rehabilitation units: a Level One hyper-acute ward and complex rehabilitation unit within the Walton Centre and two Level Two spoke rehabilitation units within Liverpool and St Helens, in addition to a Community Rehabilitation Team. An inpatient Liaison Neuropsychiatry service consisting of a Consultant Neuropsychiatrist and a Clinical Nurse Specialist cover the units. Method Electronic patient records were searched for information pertaining to Neuropsychiatry reviews undertaken on patients in the rehabilitation units. Data were collected on the number of reviews, diagnoses, previous psychiatric history, number of injuries due to suicide attempts, capacity assessments performed and number of subsequent referrals to Community Mental Health Teams (CMHT). Results Over a twelve month period, a total of 174 patients were reviewed by the Neuropsychiatry Liaison Service. 29.9% (52) of those patients had a past psychiatric history and indeed 4 of them had sustained their brain injury due to a suicide attempt. The patients were reviewed an average of 5 times during their stay on the rehabilitation unit. Capacity assessments were performed on 20 patients. The most common diagnoses seen were adjustment reaction, depression, delirium and anxiety. Of the patients reviewed, 11.5% (20) were subsequently referred on to CMHT. Conclusion This study shows the importance of Neuropsychiatry provision within Inpatient Rehabilitation units and the high level of psychiatric conditions within patients who suffer an acquired brain injury.