Psychological consultancy in mental health services: A systematic review of service, staff, and patient outcomes

Objectives Psychological consultation in mental health is an organizational intervention aiming to enable mental health care to be delivered in a more efficient manner. This review sought to: (1) clarify what theoretical models underpin consultancy, (2) define how consultancy is implemented, (3) assess the methodological rigour of the evidence base, and (4) define the outcomes achieved for services, staff, and patients. The review was focal to direct and indirect forms of consultation.

Method PRISMA guidelines were followed. Three databases were searched identifying N = 17 studies, and these were quality assessed using the QualSyst quality ratings checklist. Studies were grouped by model of consultation and outcome. A thematic analysis then clustered the patient, staff, and service outcomes into either discrepant or confirmatory evidence.

Results The most frequently adopted theoretical models underpinning psychological consultation are cognitive‐behavioural and cognitive‐analytic. Method of consultancy implementation is typically via case formulation meetings. Study quality varied from limited to strong. The main confirmatory and positive outcomes for staff are an increase in understanding and also more positive feelings towards patients, and for the service, there is a reduced need for other interventions.

Conclusions Psychological consultation appears a useful and worthwhile aspect of leadership by psychological therapists. Training in delivering consultancy needs to be well integrated into the core curricula of clinical training programmes. The evidence base is still in its infancy, and further well‐controlled research is required.

Practitioner points Psychological consultation improves staff insight and understanding of patients. Psychological consultants need to remain visible and accessible to teams and use a theoretical model to guide consultation. Training and supervision in consultation are necessary to support psychological therapists in these roles.