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.” |