Lipowski Z J
Am J Psychiatry. 1977 May;134(5):523-8. doi: 10.1176/ajp.134.5.523.
There are two major models of consultation in the field of psychiatry, differing in their goals, participants, settings, and methods. The psychiatric-therapeutic model entails provision of optimal care for the individual patient; the community mental health model involves provision of assistance to mental health caregivers. The author believes that to enhance the value of consultation the consultation should restrict his or her role to that for which he or she has been trained. Current social needs, coupled with a limited supply of consultants, suggest that psychiatric consultation should be provided within comprehensive health care systems. There is a pressing need to clarify the concepts of formulations concerning the criteria of outcome of psychiatric consultation so that evaluation of its effectiveness can be advanced.
精神病学领域有两种主要的会诊模式，它们在目标、参与者、环境和方法上存在差异。精神治疗模式需要为个体患者提供最佳护理；社区心理健康模式则涉及为心理健康护理人员提供帮助。作者认为，为了提高会诊的价值，会诊人员应将自己的角色限制在其接受过培训的范围内。当前的社会需求，加上会诊人员供应有限，表明精神病会诊应在综合医疗保健系统内进行。迫切需要澄清有关精神病会诊结果标准的表述概念，以便推进对其有效性的评估。
