An Analysis of Out-patient Services

The psychiatric out-patient department fulfils a comprehensive role in the diagnosis and treatment of a wide range of psychiatric disorders; it is no longer an annexe of the mental hospital principally concerned with providing follow-up and support for discharged patients. But despite the enormous growth of out-patient facilities and treatments, there have been few studies analysing the out-patient services. The Bethlem Royal and Maudsley Hospitals present detailed accounts of their out-patients, but although they serve a defined area their special functions possibly make their clientele unrepresentative. Diagnoses of out-patients in Buckinghamshire were analysed by Kessel and Shepherd (1962), but this survey gives no information about the treatment or disposal of patients. Innes and Sharp (1962) presented detailed statistics for combined inpatient and out-patients in the North East of Scotland, but did not separate the two classes of patients. The most comprehensive information concerning patients attending a hospital psychiatric out-patient department—their diagnosis, treatment and disposal—comes from Kessel and Hassall (1965 and 1971) in their evaluation of the functioning of the new Plymouth Nuffield Clinic, and from Kaeser and Cooper (1971) who investigated a group of general practitioner referrals to the Maudsley Hospital to assess the satisfaction gained by the patients and family doctors from such consultations.