In a pilot study, 99 patients referred from a general hospital accident and emergency department were seen by a community psychiatric nurse (CPN) using a time series design. They were categorized into those patients having a previous psychiatric history and those with none. The level of service use for the 6 months immediately prior to CPN intervention, 6 months following referral, and 6 months of follow-up indicated a very high level of psychiatric and general medical service use by this group. Referral to the CPN was associated with substantial reduction in the demands on other services made by the group with previous psychiatric history. The group with no previous history showed a decrease in total service usage at follow-up.