Who gets referred? Child psychiatric consultation in a pediatric hospital.

The authors approach the question, "Who receives a child psychiatry consultation?" in several ways. First, by reviewing the consultation patterns in a pediatric hospital over a five year period as a new array of liaison services were being provided, they found the overall consultation rate decreased. Yet in absolute numbers the referral rate for consultation around diagnostic issues remained relatively constant. This underlines the core importance of the child psychiatry consultant as diagnostician. Second, in matching a group of children receiving a psychiatric consultation against a group of children who did not, the authors found somewhat more psychosocial information recorded in the charts of the former group. However, it is doubtful that this played any direct role in the generation of the referral per se. The authors stress the finding that the pediatric hospital is a medical setting and unless the child's psychological problems impinge directly on that system, such problems are likely to remain hidden and beyond the scope of the consultation process.