A high proportion of patients in general hospitals have co-morbid mental health problems, often leading to poorer health outcomes and increased healthcare costs. For example:

• The effects of psychological morbidity in patients with chronic obstructive pulmonary disease are associated with increased lengths of stay in hospital (1)  and increased out-patients attendance (2) .
• Evidence shows that people with severe mental illness, including depression, have a 2–3 fold increased mortality rate compared to the general population which is not only caused by increased suicide but is associated with physical illness (3).
• High proportions of people with physical health conditions also have co-morbid mental health problems,  this includes 30-65% of medical in-patients (4)

A recently completed service evaluation  (5) shows that an effective liaison psychiatry service that rapidly assesses such patients is likely to improve their health outcomes, as well as saving money through:

• More effective “diversion and discharge” of patients seen in Accident and Emergency Units to more appropriate service, and early but effective discharge from general admission wards
• Quicker discharge from hospital and fewer re-admissions, resulting in reduced numbers of in-patient bed-days.
• The integration or “interface” of a comprehensive range of mental health expertise within an acute general healthcare setting, with a target for response time being one hour.

(1) Yellowlees et al. (1988) Psych. Morbidity in Patients with Life-Threatening Asthma. Medical Journal of Australia, 149, 246-249

(2) Scharloo et al. (2000) Physical and Psych. Correlates of Functioning in Patients with COPD. Journal of Asthma, 37, 17-29

(3) Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) M. De Hert a,*, J.M. Dekker b, D. Wood c, K.G. Kahl d, R.I.G. Holt e, H.-J. Möller f

(4) Gomez, J. (1987) Liaison Psychiatry: Mental Health Problems in the General Hospital.  London: Croom-Helm.

(5) The Centre for Mental Health and London School of Economics and Political Science (2011) Economic Evaluation of the RAID Service.

NHS Midlands and East have developed a workprogramme to support the effective commissioning and evaluation of RAID type services. the key objectives are:

Objective 1: Ensure all relevant departments within NHS Midlands and East are aware of the key characteristics and potential benefits of a RAID Type Service

Objective 2: NHS Midlands and East to work with Clusters and their  Local Health Economies to raise understanding and commitments to the potential benefits of the RAID type service.

Objective 3: Provide guidance and shared learning for effective Commissioning  and Implementation of Local RAID type services