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Journal article Full text available online for free

Transforming mental health care for older veterans in the Veterans Health Administration

Authors:
KARLIN Bradley E., ZEISS Antonette M.
Journal article citation:
Generations, 34(2), Summer 2010, pp.74-83. Published online.
Publisher:
American Society on Aging

Older adults often lack familiarity with mental health symptoms and services and may hold negative beliefs about mental health care that can prevent them from seeking treatment. The Veterans Health Administration (VHA) operates the largest and one of the most elaborate mental health care systems in the nation and perhaps the world. The recent history of the system is described. One successful new model for providing mental health care to older veterans that has been nationally implemented in the VHA is the integration of a full-time mental health provider on each of the more than 130 VA home-based primary care (HBPC) teams. Another major psychogeriatrics initiative involves the integration of a full-time mental health provider in VA community living centers (CLC), formerly designated as nursing home care units. It is critical that increasing national attention be devoted to the mental health needs of older Americans and that policies and processes be developed to extend the reach and potential impact of mental health care for older adults.

Journal article

Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older people

Authors:
SAMUELSSON G., et al
Journal article citation:
Health and Social Care in the Community, 11(2), March 2003, pp.95-102.
Publisher:
Wiley-Blackwell

This study was designed to describe the pattern of long-term formal support received by people with mental disorders and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support, based on a cohort of 192 people born in 1902 and 1903 in a community in Southern Sweden. They were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 and on 8 further occasions until they were 92. Participation ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% with other psychiatric diagnoses and 12% with good mental health. The last group all had physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% with good mental health received no formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other 2. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with mental disorder, including dementia, were significantly more likely to use formal support compared with people with good mental health. Social factors were the main factors predicting formal support.

Book Full text available online for free

Educator’s guide to 'an introduction to the mental health of older people' e-learning resources

Author:
SOCIAL CARE INSTITUTE FOR EXCELLENCE
Publisher:
Social Care Institute for Excellence
Publication year:
2007
Pagination:
32p.
Place of publication:
London

In these learning objects students will have the chance to explore the nature and characteristics of the ageing population in the UK, what being 'old' means, and some of the complexity surrounding the concept of 'mental health'. As this learning object presents basic facts and concepts surrounding mental health and older people, it is recommended  that students use this object as an introduction to the area.

Digital Media Full text available online for free

An introduction to the mental health of older people: an introduction to mental health and older people

Authors:
SOCIAL CARE INSTITUTE FOR EXCELLENCE, MILNE Alisoun, GEARING Brian, WARNER Joanne
Publisher:
Social Care Institute for Excellence
Publication year:
2007
Place of publication:
London

In this learning object you will have the chance to explore the nature and characteristics of the ageing population in the UK, what being 'old' means, and some of the complexity surrounding the concept of 'mental health'. As this learning object presents basic facts and concepts surrounding mental health and older people, it is recommend that you use this object to introduce yourself to this area. This learning object also contains a self-assessment section where you can test how far you have assimilated the key messages.

Journal article

Inclusion/exclusion criteria in late life depression antidepressant efficacy trials

Authors:
ZIMMERMAN Mark, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1009-1016.
Publisher:
Wiley-Blackwell

Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs. Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression. Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline. Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression (Edited publisher abstract)

Journal article Full text available online for free

Late life depression: a historical perspective upon a maturing field of inquiry

Author:
BLAZER Dan G.
Journal article citation:
Aging and Mental Health, 18(5), 2014, pp.538-539.
Publisher:
Taylor and Francis

In this editorial, the author reviews the findings of seven studies on the topic of late life depression and compares these studies with the state of the field in terms of empirical research when he wrote his 1982 book. (Original abstract)

Journal article

A family approach to delirium: a review of the literature

Author:
HALLOWAY Shannon
Journal article citation:
Aging and Mental Health, 18(2), 2014, pp.129-139.
Publisher:
Taylor and Francis

This literature review had the following objectives: (1) evaluate the current state of research into delirium management (prevention, identification, or treatment of delirium) with family approaches or involvement, (2) identify gaps and areas that require investigation, and (3) determine a future course of research. A comprehensive search of original research was conducted in six major databases using seven keywords in 2012. The literature search yielded a total of 2160 articles. Criteria for eligibility were met by a total of 11 articles. The articles were evaluated in regards to purpose, sample, research design, level of evidence, variables, and results. The literature review revealed that this topic is emergent and requires substantial additional research. The aspects of delirium care that researchers investigated were diverse and included bedside interventions (n = 3), screening strategies (n = 4), family education (n = 2), and care that employed multiple components (n = 2). Delirium outcomes improved significantly in two high-quality studies: one multi-component intervention and one bedside intervention program. Other noteworthy findings of lower quality studies warrant further examination. The review of the articles did not determine if the involvement of families in delirium management improves patient outcomes; however, the review revealed potential for program development and future courses of research.

Journal article

Psychological distress as a key component of psychosocial functioning in community-dwelling older people

Authors:
SCHNITTGER Rebecca I. B., et al
Journal article citation:
Aging and Mental Health, 16(1-2), January 2012, pp.199-207.
Publisher:
Taylor and Francis

Psychological distress is a critical issue affecting the quality of life in older adults with implications for both mental and physical health. The aim of this study was to explore the key components of psychosocial functioning in older adults with a focus on identifying the constituents of psychological distress. Another aim was to examine the relationship between these components and health outcomes such as frailty. The study was conducted at the Technology Research for Independent Living Clinic, a comprehensive geriatric assessment facility in Dublin. As part of a structured clinical assessment, 579 participants completed 9 primary psychosocial measures as well as a broad range of health and demographic secondary assessments. Principal factor analysis identified 3 core dimensions of the construct of psychosocial functioning. The first is related to a core internal component of psychological distress. The 2 other components are related to external and physiological functioning, specifically social support networks and sleep. These components, particularly psychological distress, were found to be associated with health outcomes associated with frailty.

Journal article

The relationship between exercise participation and well-being of the retired elderly

Authors:
LEE Yi-Ju, HUNG Wei-Li
Journal article citation:
Aging and Mental Health, 15(7), September 2011, pp.873-881.
Publisher:
Taylor and Francis

In Taiwan there is a popular culture among the elderly of doing exercise in public parks and squares in the early morning. The aim of this study is to examine the relationship between exercise intensity, exercise frequency and the feelings of well-being of the retired elderly. A questionnaire survey was conducted in 6 parks in Taipei from February to April 2007. A total of 352 valid questionnaires were collected. The survey found that the retired elderly participate in a wide range of sports, from light exercise such as walking to vigorous exercise such as tennis and aerobics, and their participation frequency was very high. Most of the respondents (87.2%) were defined as having positive well-being. The results showed that exercise frequency and well-being were positively correlated. However, a negative correlation was found between exercise intensity and well-being. Most of the activities participated in by the elderly were in the categories of moderate or vigorous intensity. The study suggests that the elderly felt more comfortable and gained more pleasure psychologically while participating in less intensive exercise. The article concludes by recommending that the retired elderly should take exercise as frequently as possible, but that low-to-moderate intensity exercise might be better for their psychological well-being.

Journal article

Representations of elderly with mental health problems held by psychosocial practitioners from community and institutional settings

Authors:
DALLAIRE Bernadette, et al
Journal article citation:
Social Work in Mental Health, 7(1-3), 2008, pp.139-152.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This article begins by providing an overview of the prevalence of mental health problems  among people aged 65 and older, the specific situations and needs of this population, and the services provided to them. It then briefly discusses three trends in psychosocial interventions, that is practices oriented toward recovery, empowerment, and social integration are then reviewed.. Finally, the article looks at the cumulative impacts of social representations of aging and the aged and of mental illness and the mentally ill, and how they can impede the implementation of interventions, services and programs based on recovery, empowerment and social integration approaches.

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