Psychiatric Consultation in an Intensive Care Unit

Recent years have seen the establishment of intensive care units (ICUs) in general hospitals, where medical treatment requiring constant supervision and intensive nursing care can be given. Another recent development is the interest in the use of a psychiatrist in the general hospital, especially for consultation on problems arising with medical and surgical patients. However, no publication dealing specifically with consultation to an ICU has come to my attention. There has been a shift in the focus of psychiatric consultation which parallels certain developments in psychiatry at large. Recently, "community psychiatry" has come upon the scene. This article describes the application of some of its principles to psychiatric consultation. The leverage point for the community psychiatrist is not so much the individual patient as the various care-giving persons in the community, to whom he acts as a mental health consultant. Direct interaction with patients is less his concern than indirect