ESTABLISHING A GERIATRIC PSYCHIATRIC-CONSULTATION IN A VA MEDICAL-CENTER

The authors describe the establishment of a Geriatric Psychiatry Consu ltation-Liaison Team (GPCLT) at a Veterans Administration Medical Cent er (VAMC) that previously had no organized geriatric psychiatric servi ce. Geriatric psychiatric consultation was required by three intermedi ate-care units treating older, chronically medically ill veterans with psychiatric symptoms or disorders. The GPCLT comprised a black, femal e geriatric psychiatrist and a white, male social worker. This combina tion of disciplines maximized skills, and the ethnic-gender difference s of team members addressed questions of racial tension and gender iss ues between patients and VAMC staff members. The compliance with recom mendations of the GPCLT, ranging from 89% to 98% across the three unit s, its selection as a clinical site for a university-affiliated Geriat ric Psychiatry Fellowship Program, and the increase in the total hours of social work time assigned to the GPCLT documented the positive per ception of the team by both the VAMC and the affiliated university. Sp ecific recommendations are presented for consideration by other, simil ar settings.