A survey of the first two years of a psychiatric clinic within a geriatric medical day hospital was undertaken to determine the role of such a clinic. Forty per cent of all day hospital attenders were referred for psychiatric evaluation: at least 80 per cent of these had major psychiatric diagnoses and 20 per cent had other conditions needing psychosocial intervention. Depression and dementia accounted for 62 per cent of all psychiatric referrals. Those who were referred to the psychiatric clinic were quite comparable to the unreferred group in age, sex, marital status, pre-retirement employment and source of referral to the day hospital. The outcomes of intervention at three, six and 12 months were similar in both groups but referred patients stayed longer in the program. It is concluded that such a clinic provides a necessary mental health service where it is needed.

A one year cohort of referrals (n=178) to a primary care based psychiatric clinic in a large Health Centre is described. Fears that such a clinic might detract from treatment provided for psychotic patients seemed unfounded. Waiting time for assessment was short and patients were more likely to attend than at hospital based clinics. Admission rates were considerably reduced. Contact between patients and their general practitioner seems to continue at a high level even during psychiatric intervention but half of the “frequent attender” group cease contact. The pattern of attendance on follow-up suggests that many patients may receive unnecessarily long out-patient care.

The evidence to date suggests that such clinics provide a useful service but other aspects of quality of care require evaluation.