Liaison psychiatry, also known as consultation-liaison psychiatry, is the subspecialty of psychiatry that provides psychiatric care to patients presenting in medical settings. Services have traditionally been based in general hospitals, where they provide psychiatric consultations on medical and surgical wards, in emergency departments and in out-patient clinics. In spite of recognition as a subspecialty with the achievement of faculty status within the Royal College of Psychiatrists, liaison services remain patchy. Thus, in the UK it is still a growing specialty.

Cultural challenges in liaison psychiatry

In these globalised times hospitals in Western countries, particularly in large cities, see patients from all over the world. The term ‘hyperdiversity’ has been used to refer to the mix of ethnicities, cultures and identities seen in conurbations (Kirmayer, 2007). Many of them include refugees or asylum seekers with traumatic histories and poor skills in communicating in the dominant language. These patients often do not do well in general hospitals as they are unable to express themselves. It is known that patients with mental illnesses in general hospitals experience stigmatising attitudes (Liggins & Hatcher, 2005) and experience more adverse events during their hospital stay (Daumit et al, 2006). The culturally different patient with a mental illness may thus be the victim of double jeopardy. The liaison psychiatrist, whose role goes beyond psychiatry to psychosocial advocacy (Smith, 1998), needs to have advanced skills in assessing and treating a patient from a different culture.