Broadening the state of play - the second national survey of Consultation-Liaison Psychiatry services in New Zealand, 2021.

OBJECTIVE: The original national survey of Consultation-Liaison Psychiatry (CLP) services in New Zealand (NZ) that was undertaken in 2018 (CLPSNZ-1) established a baseline but was limited in scope. The aim of the current study was to conduct a more in-depth national survey. METHOD: A 44-question survey was emailed to clinicians at each of the 16 general hospitals in NZ with specialist adult CLP services in 2021. RESULTS: Responses were obtained from all 16 CLP services. These services were found to be under-resourced (with mean total full-time equivalents of 0.26 psychiatrists and 1.10 clinicians per 100 inpatient beds, respectively), operate with highly variable service models (with major variations in operating hours and coverage of age groups, the Emergency Department and outpatients) and provide a predominantly consultation service. CONCLUSION: While many of the findings from CLPSNZ-1 remain relevant, the current survey has extended our understanding of the circumstances, achievements and challenges of this psychiatric subspecialty in NZ.

A survey of the psychiatric care provided for medically ill older adults in general hospitals in New Zealand.

OBJECTIVE: The aim of this study was to conduct an in-depth survey of the psychiatric care provided for medically ill older adults in general hospitals in New Zealand (NZ). METHOD: As part of a larger survey of Consultation-Liaison Psychiatry (CLP) services for all ages in NZ (CLPSNZ-2), a 44-question survey was emailed to clinicians who were involved in providing psychiatric care for medically ill older adults at each of the 16 general hospitals with designated CLP services. RESULTS: Responses were obtained from 22 services at 16 hospitals - 14 CLP services and eight Psychiatry of Old Age (POA) in-reach services. These services were found to be under-resourced, operate with highly variable service models, and predominantly provide inpatient consultations. Services could be conceptualised as six prototypes with variations of POA in-reach to hospitals, scope of CLP cover and collaboration between services. CONCLUSION: The heterogeneity in the psychiatric care for medically ill older adults in NZ means that there is an urgent need to develop more consistent CLP service models that better serve the specialist needs of older adults, and establish the policies, resources and standards needed to support them.