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Paediatricians and psychiatrists working together: what works best?
  1. Andrew Court
  1. Correspondence to Dr Andrew Court,Consultation Liaison Psychiatry, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; andrew.court{at}rch.org.au

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Since paediatrician Joseph Brenneman wrote of ‘the menace of psychiatry’ in 19311 complaining of the ‘psychiatrising’ of children's normal behaviour, there has been recognition that the relationship between paediatricians and child and adolescent psychiatrists has been problematic.

Fritz noted in 20032 when discussing challenges to the development of healthy collaboration between both disciplines that every 10 years or so since then there have been important reviews written by influential paediatricians and psychiatrists on the state of the relationship with problems noted and solutions offered.

Over the last 10 years there has been an emphasis on the need to support paediatricians by the trialling of collaborative approaches with psychiatrists.3 There is also recognition from some psychiatrists that they need to be more collaborative in order to continue to enjoy a satisfying professional life.4–6

There have been changes to the ways medical care is managed, with issues of cost and cost-effectiveness increasingly driving how services are delivered.7 ,8 Evidence shows that paediatricians continue to feel unskilled in managing many mental health problems but also that they perceive psychiatrists to be unavailable.9 ,10 On the other hand, despite the breadth of potentially effective treatments available to psychiatrists, there is pressure on them to focus on prescribing medication with a perception that other more fulfilling models of their work are undervalued.4

When reviewing what works best in the working relationship between paediatricians and psychiatrists, much of what has been written over many decades remains relevant and highlights the need to recognise and respect the differences between the two disciplines. Only through such understanding can the ongoing barriers to healthy collaboration be removed.

This review is written by a psychiatrist who initially trained and worked as a paediatrician. He works both in the public and private healthcare systems …

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