Audit of the first year of a psychiatric clinic at a Dublin Maternity Hospital

Objectives: The aims of the audit were to monitor the activities of the lia ison clinic over a 12 month period, to establish the number of attenders an d non-attenders and to evaluate whether the service was meeting the needs o f patients with perinatal disorders. Method: The Coombe Women's Hospital is one of three maternity hospitals in Dublin and had 6,452 deliveries and 5,273 inpatient gynaecological procedur es performed in 1994. The charts of all the patients who were given an appo intment for the psychiatric clinic between January 1 and December 31, 1994 were reviewed. Results: Fifty-six patients attended the clinic over the 12 month period, 3 8(68%) of whom were new referrals to the service. Twenty-two patients were antenatal, 20 were postnatal and 14 patients were attending the gynaecology department. Seventeen patients (30%) who were referred to the clinic faile d to attend for their first appointment. Forty-one (73%) patients had suffi cient symptomatology to make an ICD-10 diagnosis. Medication was prescribed for 58% of those who attended. Four patients were referred to their catchm ent area service for inpatient care: six patients were referred to their ca tchment area service for further outpatient care as they had psychiatric il lnesses which predated their pregnancies. Conclusions: The number of patients referred to the liaison service with po stnatal depression is remarkably less than that anticipated and there is a high rate of defaulting among first attenders. Various recommendations are made to improve the effectiveness of the service.