Child & Adolescent Psychiatry - Consult-Liaison Service (HSC)

Service Overview:

The Consultation Liaison Service is comprised of Dr. Laurence Katz, Dr. Jack Perlov,  Dr. Diana Sam, Dr. Jon Boman, Dr. Polina Anang, Mr. Peter Mary, RN, BN,  Ms. Julie Pannell, BSc., PN, Ms. Jennifer Sveinson, BSW.  It consults with staff at Children's Hospital, as well as pediatricians and family physicians in the community.  Cathy Lucas and Julie Pannell, nurse therapists, provide nurse therapy to inpatients and outpatients and Jennifer Sveinson, a social worker, provides family assessment, support and therapy.  The service meets with ward staff, physicians, and other disciplines to develop plans for the continuing care for patients in hospital and in the community. Regular and timely communication with caregivers is emphasized by the team.

Referrals to the Consultation Liaison Service are received from physicians on the wards at Children's Hospital or from consultation clinics at Children's Hospital.  The referrals primarily are from Neurology, Plastic Surgery, Respirology, Gastroenterology, Child Development, Endocrinology, Rheumatology, Oncology, Urology and Nephrology.  Referrals from the community physicians, pediatricians, community agencies or  physicians in rural settings are triaged by Centralized Intake, Child and Adolescent Mental Health.

The Consultation Liaison team regularly reviews all current cases in care.  Cases referred from the wards at Children's Hospital are seen with 24 hours of notification, Monday through Friday.  Consultation requests for self-harm behavior are seen on the same day as notification.  The waiting time for assessment ranges from one to six weeks.  Residents are integral members of the service.  They take graded responsibility in completing the initial assessment, usually complete the written report and are encouraged to actively participate in follow-up care.  Staff are actively involved in most of the consults.

The goal of this service is to assess and identify the medical, psychiatric and psychological needs of each patient and family in order to facilitate the child or adolescent's recovery of optimal functioning from an acute or chronic medical condition.  Follow-up occurs for many patients and families on a short-term basis.  Long-term psychiatric care is provided as necessary.

Commonly, children and adolescents are assessed who experience headaches, abdominal pain or a traumatic even such as a loss of limb, loss of parent, burns, or kidney transplantation.  As well, the service provides consultation regarding injurious, self-harm behavior when the child is admitted to Children's Hospital.  In addition, the service provides consultation to children and adolescents up to age 18 who have a chronic illness such as asthma, or Crohn's disease, and who seek help in making a psychosocial adjustment to the condition.  All cases seen in the Consultation Liaison Service have an active Axis III diagnosis comorbid with an Axis I or Axis II condition.  The service provides consultation and support services to pediatric oncology at Cancercare Manitoba.  Currently the service is exploring with the Pediatric Nephrology section their request for more extensive consultation liaison activity.

The service also educates psychiatric residents, pediatric residents and medical students. These trainees work with Dr. Sigurdson, Dr. Perlov, Dr. D. Sam and Dr. J. Boman on the rotation. 

The goal of this rotation is to help the trainee to better understand the psychiatric impact of psychosocial stressors, illness and family stressors on a sick child.  The biopsychosocial aspects of the care of children and adolescents receiving care at Children's Hospital are emphasized to trainees.  This provides a unique opportunity to examine the psychodynamics of physical illness in children and adolescents and understand the impact of physical illness on the maturation process in growth and development.

The service has used Manitoba Telehealth to provide follow-up in selected cases by means of a video link.  The team seems to maintain good communication with the appropriate staff at the schools of the patients.

Research is an ongoing interest of the service.

CLINICAL SERVICE MEDICAL STAFF

Dr. Laurence Katz
Service Chief
PZ162 PsycHealth Centre
771 Bannatyne Avenue
Winnipeg, Manitoba, Canada
R3E 3N4
Phone: (204) 787-7564
Fax: (204) 787-4975

Dr. Jack Perlov
Staff Psychiatrist

Dr. Jonathan Boman
Staff Psychiatrist

Dr. Diana Sam
Staff Psychiatrist

Dr. Polina Anang
Staff Psychiatrist