title: Mental healthcare for hospitalized older adults: a national survey of consultation-liaison services provided by old age psychiatrists in Ireland.
abstract: In Ireland, the population aged 65 years and over is projected to increase by 20,000 annually with the proportion of the population aged over 65 years doubling over the next 30 years. It is estimated that up to 60% of older people in hospital have or can develop a mental disorder during their admission (Royal College of Psychiatrists, 2005). The needs of older adults are distinct in many ways and a previous systematic review found that old age psychiatry services for hospitalized older adults are effective (Draper and Low, 2005). With regard to models of service provision, there is evidence that a liaison type service is superior to consultation only. The latter service is limited and reactive whereas a dedicated liaison service is proactive and is more likely to succeed in having good mental healthcare adopted as the standard of care within a hospital (Royal College of Psychiatrists, 2005). Consultation-Liaison (CL) services have been associated with decreased psychiatric morbidity, improved function, reduced length of stay, fewer readmissions, and increased cost-effectiveness compared with usual care (Royal College of Psychiatrists, 2005, Parsonage and Fossey, 2011). In Ireland, specialist community services for older adults have developed steadily, while CL services have remained relatively neglected with no specific recommendations regarding CL services for older adults in national guidelines (Department of Health, 2006). This is not necessarily out of step with international trends where in spite of increasing rates of referral to CL services for older adults in the United Kingdom and the United States there is a reported lack of emphasis upon this important area of service provision (Andersonet al., 2011). Consequently, little is known about age-specific CL services for older adults in Ireland, and service development has proceeded in an unstructured way. In particular, it is not known whether such a service is available within each area and if so, what the nature and extent of the services provided are.
authors.affiliation: Department of Old Age Psychiatry, St Vincent's University Hospital, Dublin, Ireland Email: gallagherdamien@hotmail.com.
authors.forename: Damien
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: Department of Old Age Psychiatry, St Vincent's University Hospital, Dublin, Ireland Email: gallagherdamien@hotmail.com.
authors.forename: Colm
authors.initials: C
authors.lastname: Cooney
authors.affiliation: Department of Old Age Psychiatry, St Vincent's University Hospital, Dublin, Ireland Email: gallagherdamien@hotmail.com.
authors.forename: Sinead
authors.initials: S
authors.lastname: Murphy
authors.affiliation: Department of Old Age Psychiatry, St Vincent's University Hospital, Dublin, Ireland Email: gallagherdamien@hotmail.com.
authors.forename: Aideen
authors.initials: A
authors.lastname: Freyne
authors.affiliation: Department of Old Age Psychiatry, Mater Hospital, Eccles Street, Dublin, Ireland.
authors.forename: Margo
authors.initials: M
authors.lastname: Wrigley