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Table 3 Discussion summaries for patients with active behavioral health condition but did not receive consult

From: Psychiatric consultation requests by inpatient medical teams: an observational study

Patient Diagnosis Discussion Summary
1 Cirrhosis (active drinker) No discussion of alcohol use or any other social issues. Medical discussion focused on hernia, potential need for paracentesis, and leaking of fluid.
2 Cirrhosis (active drinker) Continued alcohol use briefly mentioned: “He says he’s stopped drinking but…” No further discussion.
3 Cirrhosis (active drinker) Attending engaged patient utilizing motivational interviewing techniques (e.g., “what do you like/dislike about your drinking?”). Patient agreed to speak with Social Work services. Team referred patient to Social Work to address multiple social issues besides alcohol use, including housing and transportation.
4 Passive suicidal ideation Team discussed mental health issues as chronic and considered suicidal ideation as passive. Psychiatric issues already being followed as outpatient.
5 Cirrhosis (active drinker) Continued alcohol use discussed directly but not actionably addressed: “he stopped drinking when he started feeling poorly… it’s the culture of alcoholism… he’ll just come back after a few drinks.”
6 Cirrhosis (active drinker) Continued alcohol use was discussed in relation to his follow-up medical care but not actionably addressed:
-“He still drinks.”
-“He’s a smart man… He’s an alcoholic, too. Nothing against him, but if he goes home and starts drinking, he’ll miss his appointments.”
7 Alcohol withdrawal Alcohol use was discussed in relation to symptoms of withdrawal: “sounds like he was in withdrawal when he came in, and he’s about to not be drunk.” No other discussions.
8 Alcohol withdrawal Team suggested referral to patient. Patient refused both psychiatry and LCDC services. Team physician told patient: “you’ve got to stop the drinking. It’s going to kill you.”
9 CVA, suicidal ideation Patient too disoriented due to CVA.
10 Gangrene, PTSD Psychiatry consult was discussed for a capacity evaluation. Patient waiting to be discharged. The discharge physician suggested to intern: “you can make a judgement on capacity.”