The authors describe the development of an affective disorders
consultation service that implemented a biopsychosocial model of
subspecialty consultation within a university-affiliated community mental
health center. They retrospectively analyzed the first 2 years of
consultations, assessing the process of consultation and examining patterns
of consultee inquiries and consultation recommendations. Consultants
recommended combined psychopharmacologic and psychodynamic therapies for
most patients and found psychodynamic psychotherapy strikingly overlooked
by consultees, all of whom were psychiatrists or other mental health
professionals. This evaluation documents the psychiatric consultees'
deemphasis of the biopsychosocial perspective in clinical practice.