Boosting integration of physical and mental health: The impact of increasing psychiatrists in general hospitals without psychiatric Ward

Abstract

Objective

It remains unclear whether general hospitals without psychiatric wards can provide sufficient services for both physical and mental health needs, as they often lack adequate psychiatrists, primarily due to cost constraints. This article explores the relationship between the number of full-time psychiatrists and functionality for integrating physical and mental health services in these settings.

Methods

The Medical Policy Committee of the Japanese Society of General Hospital Psychiatry conducted a nationwide survey in 2022 to evaluate the detailed scope and volume of service of psychiatric departments in general hospitals without a psychiatric ward. The survey collected data related to scope and volume of service, including the availability of on-call services, the number of patients seen in outpatient settings, and the number of consultation-liaison services provided. The results were analyzed based on the number of full-time psychiatrists, with and without data from university hospitals, and categorized by hospital type. To account for confounding factors, multivariable regression analyses were also performed.

Results

Broader scope and higher vollume in essential services was observed depending on the number of full-time psychiatrists, including on-call services, outpatient services, and consultation-liaison services, especially pediatric, anorexia, and perinatal psychiatric issues. Hospitals with multiple full-time psychiatrists offered broader services, a scope beyond the capacity of a single full-time psychiatrist, as confirmed by multivariable analyses. University hospitals offered the widest range of psychiatric services.

Conclusions

Despite often being underestimated due to cost constraints, having multiple full-time psychiatrists in a general hospital without a psychiatric ward is essential for supporting the broader scope needed to integrate physical and mental health services.