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Emergency psychiatric assessments: implications for senior house officer training

Public Health Medicine, Telford and Wrekin, PCT

Seren Roberts, Research Fellow

Psychological Medicine, WMI Academic Unit, Wrexham LL13 7YP, e-mail: seren.roberts{at}new-tr.wales.nhs.uk

Gary P. Slegg, Research Fellow and David B. Menkes, Professor of Psychological Medicine

North Wales Section of Psychological Medicine, Wrexham

Declaration of interest

None.

AIMS AND METHOD

In order to examine the opportunities for senior house officers (SHOs) to undertake emergency psychiatric assessments we conducted a retrospective cohort study of such assessments in a district general hospital.

RESULTS

Senior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P<0.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested. Senior house officers continue to undertake more assessments out of hours than any other group (P<0.01).

CLINICAL IMPLICATIONS

Although the introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for SHOs to undertake emergency assessments has been reduced, particularly with regard to assessment of suicidal risk following self-harm. These results suggest the need for better monitoring of SHO experience, particularly in the light of service developments that have an impact on psychiatric training.

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