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Out-patients: a necessary evil?

Published online by Cambridge University Press:  02 January 2018

MacDara McCauley  and
Curtis Obadan
MacDara McCauley
Affiliation:
St Brigid's Hospital, Ardee Co Louth, Ireland, email: macdara.mccauley@hse.ie
Curtis Obadan
Affiliation:
UCD Mater Rotational Training Scheme
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Abstract

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Type
The columns
Information
Psychiatric Bulletin , Volume 33 , Issue 5 , May 2009 , pp. 196
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2009

Recently, Magnes (Psychiatr Bull 2008; 32: 458–60) conducted a survey of patient attendance posing the question ‘Are out-patient appointments a necessary evil?’ The need for out-patient appointments was both queried Reference Killaspy1 and robustly defended. Reference Holloway2 Frequently, when discussing the role of such appointments the focus is on attendance. Reference Mitchell and Selmes3,Reference Kelly4 However, research addressing other aspects would greatly benefit psychiatry.

We believe that the following issues could be considered: what is the purpose of out-patient appointments? (possible responses: (a) review mental state, adherence, risk, etc.; (b) opportunity for the patients to ask questions; (c) update the GP and/or other services involved; (d) consider referral to other members of the multidisciplinary team or other services); how often should we see patients and for how long? Furthermore, guidance on appropriate discharge procedures would be very helpful.

Finally, we would like to echo Holloway's Reference Holloway2 suggestion that ‘a more nuanced discussion’ on that ‘necessary evil’ is urgently required.

References

1 Killaspy, H. Why do psychiatrists have difficulty disengaging with the out-patient clinic? Invited commentary on … Why don't patients attend their appointments? Advan Psychiatr Treat 2007; 13: 435–7.Google Scholar
2 Holloway, F. Engaging with the out-patient clinic: don't throw the baby out with the bath water. Advan Psychiatr Treat 2008; 14: 159–60.Google Scholar
3 Mitchell, AJ, Selmes, T. Why don't patients attend their appointments? Maintaining engagement with psychiatric services. Advan Psychiatr Treat 2007; 13: 423–34.Google Scholar
4 Kelly, BD. Internal audit of attendances at a psychiatry outpatient clinic. Irish J Psychol Med 2008; 25: 136–40.CrossRefGoogle Scholar
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