Psychiatric discharge summaries in the South East Thames region

Abstract

Patients discharged after acute psychiatric admission are vulnerable, and need continuing care in the community. For these people and their families, the first two weeks after discharge is a critical time. This is when problems arise, support is needed, drugs run out, and default most likely. Care may be shared between psychiatrist, community psychiatric nurse, general practitioner and other health personnel. It is therefore essential to identify the roles and responsibilities of all involved in follow-up care. Studies have shown that information needed by general practitioners includes differential diagnosis, management, treatment on discharge, prognosis, what patient and relatives were told, future plans which specify the roles and responsibilities of all involved, as well as the date of any follow-up appointment. Moreover this information is needed within two weeks of discharge. Without this information effective follow-up is unlikely to occur. The early discharge summary provides this vital information in the immediate post-discharge period. This is quite distinct from the final report which usually takes a few weeks to be sent. It is therefore important to identify current psychiatric practice relating to the initial discharge summary.