The Future of Inpatient C-L Psychiatry: A 'Hot Topic' Evidence-based Practice Update and Open Forum. Sponsored by the Journal of the Academy of Consultation-Liaison Psychiatry (JACLP)

Background:

Inpatient care is core to the history and practice of C-L psychiatry. But how exactly should it be delivered? Over the years, there have been debates about the relative merits of consultation versus liaison. More recently, new models have been developed such as proactive consultation and integrated C-L psychiatry. Which, if any, of these models is evidence-based? This question is currently a hot topic for C-L psychiatrists as we receive the results from The HOME Study, the largest C-L psychiatry trial ever completed. We will provide an update of the evidence in this workshop and examine what it means for the future of our field.

Approach:

In this workshop, attendees will consider the evidence for the effectiveness of different models of inpatient C-L psychiatry across the lifespan. They will be asked to consider the strengths and limitations of the evidence, to discuss their own views of the value of different types of inpatient C-L psychiatry, and to debate whether prioritizing inpatient care is a good use of C-L psychiatry resources. A web-based audience response system will be used to characterize the attendees and enhance their engagement throughout the session. More than half of the workshop will be dedicated to audience discussion and debate, with an emphasis on peer-to-peer learning.

Format:

5 mins: Dr. Ben Lee will introduce the speakers and the agenda for the open forum.

15 mins: Dr. Jane Walker will summarize the evidence from a systematic review of randomized trials of C-L psychiatry and the recently completed HOME Study, a 2,744 patient trial which evaluated proactive integrated inpatient C-L psychiatry. She will describe strengths and limitations of the evidence, including its relevance to marginalized groups.

10 mins: Dr. Michael Sharpe will report on the clinical lessons from delivering proactive integrated C-L psychiatry to more than 1000 inpatients, using quantitative and qualitative data from The HOME Study.

10 mins: Dr. Jim Levenson will discuss the implications of the evidence presented for the future of inpatient C-L psychiatry from the perspective of a senior C-L psychiatrist and lead investigator of an earlier landmark trial of inpatient C-L psychiatry.

10 mins: Dr. Elizabeth Madva will offer the perspective of an early career C-L psychiatrist, with a lifetime of clinical practice ahead of her, on where inpatient C-L psychiatry might go next.

40 mins: Dr. Ben Lee, the editor of JACLP, will lead an audience survey, discussion, and debate. The intention is for a summary of this session to be published in JACLP.