The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used. The videoconferencing system was positively received by both patients and doctors. Both doctors and patients preferred communication modes with visual cues. However, there were few significant differences between communication modes when using single measures; only multiple levels of analysis can adequately assess the differences between such modes of communication.

A comparison of communication modes in adult psychiatry.

Despite the increased availability of psychotherapy within the NHS, inequalities remain (Holmes & Lindley, 1989). Traditionally, psychotherapy ser vices have been provided from teaching centres in cities and patients have had to travel for treatment. This may account in part for the middle-class predo minance in psychotherapy patients and Holmes ( 1991) has identified the need for psychotherapists to reach out and cater for the disadvantaged in large housing estates and rural areas. While services are changing to meet such needs (Pedder, 1989)there are powerful economic restrictions on service expansion. The potential for communications technology such as interactive television to aid the delivery of general psychiatric services has been reviewed by McLaren et al (1992) and similar arguments apply to the delivery of psychotherapy. This study was performed as part of a project to use a new communications technology, computer based interactive television, to aid the delivery of psychiatric services including psychotherapy. The aim was to get a detailed description of professional user responses to using the system for assessing patients for psychotherapy as a preliminary to a clinical trial.

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Assessment for psychotherapy by interactive television suitable for transmission through telephone links

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A pilot study on the use of the telephone in an acute psychiatric service

Objective: An audit was carried out to evaluate the performance of a telephone consultancy service in adolescent psychiatry. Its objective was to answer the following questions: What does a telephone consultancy service actually do? Is it worth having? If so, how can we improve it? Method: Proforma data sheets on 69 consecutive calls to the Telephone Consultancy Service over a 16-month period were analysed. Results: Seventy-seven percent of enquirers used the service to request a referral or to ask about the appropriateness of referral but only 46% of enquiries were responded to in this way. Twenty-two percent of enquiries were given counselling or advice on how to proceed with the cases themselves. Almost 50% of calls came from the social work department and they enquired principally about conduct problems (27% of their calls) and sexual abuse victims (18% of their calls). General practitioners infrequently used the service (7 calls over a 16-month period). Conclusions: These findings appear to indicate that a telephone consultancy service can provide a counselling service and highlight community resources that may be overlooked by other agencies. However, infrequent use of the service by general practitioners suggests that there has been poor dissemination of information about the service – therefore it is important to bolster awareness of the service itself on a periodic basis amongst potential users.

Telephone consultancy in adolescent psychiatry: an audit

Demographic, economic and social changes over the next few decades are likely to have a significant effect on the care of the elderly. This personal view, from a United Kingdom perspective, examines some of these changes and assesses the impact they may have on the prevalence and treatment of depression in older people. Strategies for minimizing the marginalization of this group are discussed.

Depression in Older People: What does the Future Hold?

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P. M. McLaren

Papers

Interactive television in psychiatry