COVID-19-related consultation-liaison (CL) mental health services in general hospitals: A perspective from Europe and beyond

Rainer Schaefert; Barbara Stein; Gunther Meinlschmidt; Noa Roemmel; Jordi Blanch; Birgitte Boye; Eduardo Carqueja; Tiziano De Matteis; Peter Dineen; Anne M Doherty; Silvia Ferrari; Victoria Lanvin; William Lee; Gilbert M D Lemmens; Cédric Lemogne; Krzysztof Małyszczak; António Mendes-Pedro; Ali-Akbar Nejatisafa; Sami Räsänen; Benjamin Rosen; Frederico Simões do Couto; Markos Syngelakis; Ilaria Tarricone; Christina M Van der Feltz-Cornelis; Christian G Huber; Christian Fazekas; Frank Vitinius

doi:10.1016/j.jpsychores.2023.111183

COVID-19-related consultation-liaison (CL) mental health services in general hospitals: A perspective from Europe and beyond

J Psychosom Res. 2023 Apr:167:111183. doi: 10.1016/j.jpsychores.2023.111183. Epub 2023 Feb 10.

Authors

Rainer Schaefert¹, Barbara Stein², Gunther Meinlschmidt³, Noa Roemmel⁴, Jordi Blanch⁵, Birgitte Boye⁶, Eduardo Carqueja⁷, Tiziano De Matteis⁸, Peter Dineen⁹, Anne M Doherty¹⁰, Silvia Ferrari¹¹, Victoria Lanvin¹², William Lee¹³, Gilbert M D Lemmens¹⁴, Cédric Lemogne¹⁵, Krzysztof Małyszczak¹⁶, António Mendes-Pedro¹⁷, Ali-Akbar Nejatisafa¹⁸, Sami Räsänen¹⁹, Benjamin Rosen²⁰, Frederico Simões do Couto²¹, Markos Syngelakis²², Ilaria Tarricone⁸, Christina M Van der Feltz-Cornelis²³, Christian G Huber²⁴, Christian Fazekas²⁵, Frank Vitinius²⁶

Affiliations

¹ University of Basel and University Hospital Basel, Department of Psychosomatic Medicine, Basel, Switzerland. Electronic address: rainer.schaefert@usb.ch.
² Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg, General Hospital, Germany.
³ University of Basel and University Hospital Basel, Department of Psychosomatic Medicine, Basel, Switzerland; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland; Department of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Berlin, Germany.
⁴ University of Basel and University Hospital Basel, Department of Psychosomatic Medicine, Basel, Switzerland.
⁵ Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Catalonia, Spain; University of Barcelona, Catalonia, Spain; Center of Biomedical Network Research on Mental Health (CIBERSAM), Spain.
⁶ Psychosomatic and Consultation-liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of behavioral medicine, University of Oslo, Oslo, Norway.
⁷ Serviço de Psicologia do Centro Hospitalar Universitário de S. João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
⁸ Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy.
⁹ Department of Psychiatry & Neurobehavioral Science, University College Cork & Cork University Hospital, Ireland; Department of Child & Adolescent Psychiatry, Cork University Hospital, Cork, Ireland.
¹⁰ Mater Misericordiae University Hospital, Dublin, Ireland; University College Dublin, Dublin, Ireland.
¹¹ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Dipartimento ad attività integrata di Salute Mentale e Dipendenze Patologiche, USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
¹² Department of Psychosomatic and Consultation-Liaison Psychiatry, Hôpital Sacré-Coeur de Montréal, and University of Montreal, Quebec, Canada.
¹³ Cornwall Foundation Trust, United Kingdom; University of Exeter, United Kingdom.
¹⁴ Department of Psychiatry, Ghent University Hospital, Ghent, Belgium; Department Head and Skin - Psychiatry, Ghent University, Ghent, Belgium.
¹⁵ Université Paris Cité, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France.
¹⁶ Division of Psychotherapy and Psychosomatics, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
¹⁷ Instituto Ciências da Saúde, Universidade Católica Portuguesa, Lisboa, Portugal.
¹⁸ Psychosomatic Research Center, Department of Psychiatry, Tehran University of Medical Sciences (TUMS), Iranian Association of Psychosomatic Medicine, Iran.
¹⁹ Faculty of Medicine, Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, Oulu, Finland and Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
²⁰ Sinai Health, Department of Psychiatry and University of Toronto, Ontario, Canada.
²¹ Faculdade de Medicina, Universidade Católica Portuguesa, Lisboa, Portugal.
²² Division of Consultation-Liaison Psychiatry and Psychosomatics, First Department of Psychiatry, Aristotle University of Thessaloniki, G.H. Papageorgiou, Thessaloniki, Greece.
²³ Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom.
²⁴ University of Basel, Department of Psychiatry (UPK), Basel, Switzerland.
²⁵ Medical University of Graz, Department of Medical Psychology and Psychotherapy, Graz, Austria.
²⁶ Department of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

Abstract

Objective: The COVID-19 pandemic posed new challenges for integrated health care worldwide. Our study aimed to describe newly implemented structures and procedures of psychosocial consultation and liaison (CL) services in Europe and beyond, and to highlight emerging needs for co-operation.

Methods: Cross-sectional online survey from June to October 2021, using a self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies, working groups, and heads of CL services.

Results: Of the participating 259 CL services from Europe, Iran, and parts of Canada, 222 reported COVID-19 related psychosocial care (COVID-psyCare) in their hospital. Among these, 86.5% indicated that specific COVID-psyCare co-operation structures had been established. 50.8% provided specific COVID-psyCare for patients, 38.2% for relatives, and 77.0% for staff. Over half of the time resources were invested for patients. About a quarter of the time was used for staff, and these interventions, typically associated with the liaison function of CL services, were reported as most useful. Concerning emerging needs, 58.1% of the CL services providing COVID-psyCare expressed wishes for mutual information exchange and support, and 64.0% suggested specific changes or improvements that they considered essential for the future.

Conclusion: Over 80% of participating CL services established specific structures to provide COVID-psyCare for patients, their relatives, or staff. Mostly, resources were committed to patient care and specific interventions were largely implemented for staff support. Future development of COVID-psyCare warrants intensified intra- and inter-institutional exchange and co-operation.

Keywords: COVID-19; Consultation and liaison psychiatry; Liaison psychiatry; Mental health care; Multinational; Psychiatry; Psychology; Psychosomatics.

MeSH terms

COVID-19*
Cross-Sectional Studies
Europe
Hospitals, General
Humans
Mental Health Services*
Pandemics
Referral and Consultation