Consultation-liaison psychiatry services: A survey of medical institutes in India

AIM: The aim of this study was to evaluate the consultation-liaison psychiatry (CLP) training and services in India. METHODOLOGY: An online survey was conducted involving at least one faculty member from the department of psychiatry working in various institutes providing postgraduate training in psychiatry. RESULTS: A total of 90 faculty members from different postgraduate institutes across the country participated in the online survey. In three-fourth of the institutes, the CLP services were provided in the form of on-call services with a three-tier system (i.e., CLP team comprising of faculty member, a senior resident, and a junior resident) existing in only about one-third of the institutes. In majority (60%) of the institutes, junior resident was the first-line person responding to the call of other specialists. On an average, CLP teams receive 7.33 calls per day from various clinical departments with a range of 0–20. Among the three most common psychiatric syndromes seen in CLP setting, delirium figured as one of the three most common diagnoses among 79 (87.8%) institutes, and this was followed by substance use disorders (70%), self-harm (60%), and depression (38.9%). Specific CLP posting for junior and senior residents exists only in 28.9% and 12.2% of the institutes, respectively. Joint academic activities with other departments are conducted in 42.2% of the institutes. Regarding research, very few research projects are carried out in the area of CLP. Majority of the participants felt that CLP should be given equal importance or more importance than other subspecialties such as child psychiatry, addiction psychiatry, and geriatric psychiatry in postgraduate training programs. Almost all the participants felt that having good knowledge of CLP helps in managing psychiatric patients in better way. All the participants reported that improving focus on CLP psychiatry will help in reducing stigma attached to mental illnesses and improve the training of postgraduates and the undergraduates. CONCLUSIONS: There is a need to improve the CLP services, training program, and research in various medical institutes to provide good mental healthcare to medically ill patients.