Hines Declan, Ford Tamsin, Westwood Sophie, Barrett Jessica R, Westphal Birgit, Davies Virginia, Lee William
School of Clinical Medicine, University of Cambridge, UK.
Department of Psychiatry, University of Cambridge, UK.
BJPsych Open. 2023 Feb 1;9(2):e30. doi: 10.1192/bjo.2022.638.
Liaison psychiatry provision for children and young people in England is poorly evaluated.
We sought to evaluate paediatric liaison psychiatry provision and develop recommendations to improve practice.
The liaison psychiatry surveys of England (LPSE) cross-sectional surveys engage all liaison psychiatry services in England. Services are systematically identified by contacting all acute hospitals with emergency departments in England. Questions are developed in consultation with NHS England and the Royal College of Psychiatrists' Faculty of Liaison Psychiatry, and updated based on feedback. Responses are submitted by email, post or telephone Questions on paediatric services were included from 2015 (LPSE-2), and we analysed data from this and the subsequent four surveys.
The number of acute hospitals with access to paediatric liaison psychiatry services increased from 29 (15.9%) in 2015 to 46 (26.6%) in 2019, compared with 100% provision for adults. For LPSE-4, only one site met the Core-24 criteria of 11 full-time equivalent mental health practitioners and 1.5 full-time equivalent consultants, and for LPSE-5, just two sites exceeded them. Acute hospitals with access to 24/7 paediatric liaison psychiatry services increased from 12 to 19% between LPSE-4 and LPSE-5. The proportion of paediatric liaison psychiatry services based offsite decreased from 30 to 24%.
There is an unacceptable under-provision of paediatric liaison psychiatry services compared with provision for adults. Number of services, staffing levels and hours of operation have increased, but continued improvement is required, as few services meet the Core-24 criteria.
英国针对儿童和青少年的联络精神科服务评估不足。
我们试图评估儿科联络精神科服务，并提出改进实践的建议。
英格兰联络精神科调查（LPSE）横断面调查涵盖了英格兰所有的联络精神科服务。通过联系英格兰所有设有急诊科的急症医院来系统地确定服务机构。问题是在与英国国民医疗服务体系（NHS）英格兰和皇家精神科医学院联络精神科分会协商后制定的，并根据反馈进行更新。回复通过电子邮件、邮寄或电话提交。关于儿科服务的问题从2015年（LPSE - 2）开始纳入，我们分析了此次及随后四次调查的数据。
能够提供儿科联络精神科服务的急症医院数量从2015年的29家（15.9%）增加到2019年的46家（26.6%），而成人服务的提供率为100%。对于LPSE - 4，只有一个机构达到了相当于11名全职精神科医生和1.5名全职顾问的Core - 24标准，对于LPSE - 5，只有两个机构超过了该标准。在LPSE - 4和LPSE - 5之间，能够提供全天候儿科联络精神科服务的急症医院从12%增加到19%。非现场儿科联络精神科服务的比例从30%降至24%。
与成人服务相比，儿科联络精神科服务的提供情况令人无法接受地不足。服务数量、人员配备水平和运营时间都有所增加，但仍需持续改进，因为很少有服务机构达到Core - 24标准。
