DETERMINING THE EFFECT THAT CONSULTATION-LIAISON PSYCHIATRY IN PRIMARY-CARE HAS ON FAMILY PHYSICIANS PSYCHIATRIC KNOWLEDGE AND PRACTICE

The impact of a community-based consultation-liaison (C-L) psychiatry service on family physicians' levels of psychiatric knowledge, diagnos tic and treatment confidence, and patterns of referral to mental healt h care agencies was evaluated over a 12-month period. the physicians w ith long-term access to the C-L service had higher levels of psychiatr ic knowledge than those with short-term or no access. However, there w as no evidence that the C-L service produced changes in the physicians ' levels of clinical confidence, referral likelihood, or psychiatric k nowledge during the evaluation period. Significant predictors of psych iatric knowledge were age (younger) and gender (women). The participat ing physicians were highly satisfied with the service and preferred it over other possible referral agencies. However, community C-L service s in family practice appear to have a limited role in the provision of psychiatric care and are not an efficient way for improving family ph ysicians' levels of psychiatric knowledge or altering their practices. The appropriate role of community C-L psychiatry may be as one compon ent of a comprehensive service-delivery strategy integrated within ong oing, formal family-physician educational programs.