Patients must receive psychological care

Care is not just about physical symptoms

All hospital staff should be able to provide patients with good psychological care, a report says.

The study, by the Royal College of Physicians and Royal College of Psychiatrists, stresses how important it is that patients' psychological problems are properly dealt with.

The two colleges have drawn up a practical guide that outlines common psychiatric syndromes and offers advice on how best they should be tackled.

We hope that physicians using this book will be better able to look after patients with minor psychological conditions

Professor Roy Pounder

The report says patients with medical conditions often suffer psychological problems as a result of their illness.

However, this can sometimes go unrecognised as medical staff concentrate on the physical disease.

In addition, many patients have medically-unexplained physical symptoms, sometimes the result of an underlying psychological problem which may not have been diagnosed.

The report aims to increase clinicians' knowledge of psychological problems and their treatment to improve the care of such patients.

Two-way exchange

The report stresses that effective communication is based on a two-way exchange of information.

It is important, it says, that doctors should take time to ask patients about their concerns and beliefs and to make sure that they understand the health information they are given.

Professor Roy Pounder, clinical vice president of the Royal College of Physicians, told BBC News Online that mental health problems were relatively common among people who were receiving hospital treatment for physical conditions.

It was not surprising that seriously ill people may become depressed about their condition, he said.

However, in some cases problems could be directly linked to toxins accumulating in the body as a result of physical disease.

Symptoms can include self-harm and abuse of drink and drugs.

"We hope that physicians using this book will be better able to look after patients with minor psychological conditions without involving psychiatrists.

"But we also hope it will remind people who commission services of the importance of the emerging specialty of liaison psychiatry.

"Part of the problem is that mental health services have been moved into the community away from acute trusts, but liaison psychiatrists specialise in being on hand to provide help within hospitals."

Dr Geoffrey Lloyd, chair of the working party and consultant liaison psychiatrist at the Royal Free Hospital, London, echoed the need for a closer involvement of mental health specialists in a hospital setting.

He said: "The key to delivering a high-quality service for patients with psychological problems in general hospitals is a multi-disciplinary liaison psychiatry team based at the general hospital site."