Recent changes in consultation-liaison psychiatry. A blueprint for the future.

To better understand the changes in the past 5 years on consultation-liaison (C-L) services in the United States, 119 university programs were surveyed. The return response was 64%. Of the 76 respondents, 32% had decreased funding, 54% no changes or stable finding, and 14% improved funding. Nonetheless, 57% of the programs reported funding difficulties as a major problem. Understaffing was reported by 51% of the programs. Liaison activities have ceased or are reduced in 70% of the programs; 15% reported an increase in liaison, particularly for transplantation. C-L services have been affected by illness acuity (68%), shorter hospital stays (79%), and older populations (54%). The diagnostic mix shows increases in HIV-related disorders, drug abuse, and delirium. The discussion includes recommendations for C-L services given these findings.