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The mental health of older people: taking a long view
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- Journal of Integrated Care, 16(5), October 2008, pp.4-13.
- Publisher:
- Emerald
This article sets out some of the challenges facing commissioners of mental health services for older people, and uses recommendations from a recent inquiry to outline possible commissioning objectives.
The importance of collaborative theory in older people's services
- Authors:
- ANDREWS Tresa, READ Jessica
- Journal article citation:
- Journal of Integrated Care, 17(2), April 2009, pp.35-40.
- Publisher:
- Emerald
The article shows how Southwark and Salford have attempted to bring alive government guidance by developing a mental health resource for those working at the intersection with integrated mainstream care. The solution was the Southwark Mental Health Intermediate Care team and Salford Intermediate Care Psychology and Counselling services. Although a local context receptive to partnership working was important, connecting collaborative theory with practice was crucial to the successful development of this resource.
Harm reduction among at-risk elderly drinkers: a site-specific analysis from the multi-site Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study
- Authors:
- LEE Heather Sophia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(1), January 2009, pp.54-60.
- Publisher:
- Wiley
A site-specific secondary data analysis of Primary Care Research in Substance Abuse and Mental Health for Elders study (PRISM-E) was used to assess the efficacy of a harm-reduction based intervention to enhance access to treatment and clinical outcomes among elderly at-risk drinkers. Thirty-four at-risk drinkers age 65 or older who were randomized into one of two treatment conditions: an integrated care condition which incorporated a harm-reduction based approach to treatment and an enhanced referral condition. Access to subsequent services and clinical outcomes were examined 6 months post index-interview date. Clinical outcomes included changes in the number of drinks in the week prior to assessment, changes in the number of binges in the past 3 months prior to assessment, and changes in scores on the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G). At-risk drinkers in the integrated care condition were more likely to access treatment than at-risk drinkers assigned to the enhanced referral condition. Among those who received treatment, there were no differences in the total amount of treatment visits or in the number of brief alcohol interventions received among at-risk drinkers in the two conditions. However, those in integrated care condition received services sooner than those in the referral condition. Those in the integrated care condition showed a significant decrease in the number of drinks in the past week and in the number of binge drinking episodes in the past 3 months while there were no significant changes in these outcomes among the at-risk drinkers in the enhanced referral condition. At-risk drinkers in the integrated care condition were more likely to access treatment and decrease harmful drinking behaviours than those in the enhanced referral condition. Implications for future research and treatment are discussed.
Everybody's business - whole people or whole systems? Key issues for delivering mental health services to older people
- Author:
- HITCHON Gil
- Journal article citation:
- Journal of Care Services Management, 1(4), July 2007, pp.327-340.
- Publisher:
- Taylor and Francis
This article analyses the key elements of 'Everybody's Business', published by the Care Services Improvement Partnership (CSIP), so as to provide a checklist of useful issues and actions to take into consideration when developing and delivering services for older people with mental health needs. Other key publications are also identified. The guidance is felt to be comprehensive expect for one key area: the aspirations of the service users and placing them in the context of family, friends and the community. The need to take into account the whole person, not just whole systems, is identified and a way of building this into the Department of Health's model is suggested.
Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes
- Authors:
- SIREY Anne, et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 27(3), 2015, pp.254-269.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The goal of this pilot programme was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomised to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice. (Edited publisher abstract)
Integrating mental health services for older people in England - from rhetoric to reality
- Authors:
- TUCKER Sue, et al
- Journal article citation:
- Journal of Interprofessional Care, 23(4), July 2009, pp.341-354.
- Publisher:
- Taylor and Francis
The provision of integrated, person-centred care is particularly important for older people with mental health problems. Nevertheless, a series of reports at the end of the last century highlighted unacceptable differences in collaborative working practices in England, variations that a national service framework specifically aimed to address. This study utilised a cross-sectional survey of old age psychiatrists to explore the extent to which, some three years after the publication of this guidance, structures to deliver integrated care across the interfaces between specialist old age mental health and primary, acute and social care services were in place. Three hundred and eighteen (72%) consultants responded. Measures to facilitate integrated practice were generally poorly developed: many areas missed targets to agree protocols for the management of older people with mental health problems with primary care; more than 45% of respondents reported the presence of fewer than two of four indicators of integration with the acute sector; and approaching 30% of respondents reported the presence of fewer than four of 13 markers of integration with social care. The implications of these findings and the challenges inherent in providing integrated care for this client group are discussed.
Equality in later life: a national study of older people's mental health services
- Author:
- HEALTHCARE COMMISSION
- Publisher:
- Healthcare Commission
- Publication year:
- 2009
- Pagination:
- 37p.
- Place of publication:
- London
This study of older people's mental health services assessed available national data and visited specialist mental health trusts. The interview tool covered questions relation to several of the core standards used by the Healthcare Commission to assess trusts' performance. The key findings are reported in four main themes: age discrimination, the quality of inpatient care, the comprehensiveness of services; and working with other organisations (how specialist services worked with primary care, adult social services and acute hospitals). The findings highlight strengths and weakness of services, and key priorities for improvement are included.
Integrated specialty mental health care among older minorities improves access but not outcomes: results of the PRISMe study
- Authors:
- AREAN Patricia A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(10), October 2008, pp.1086-1092.
- Publisher:
- Wiley
In this secondary data analysis of Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRIMSe) study, the authors hypothesized that older minorities who receive mental health services integrated in primary care settings would have greater service use and better mental health outcomes than older minorities referred to community services. The authors identified 2,022 (48% minorities) primary care patients in the US of 65 years and older, who met study inclusion criteria and had either alcohol misuse, depression, and/or anxiety. They were randomized to receive treatment for these disorders in the primary care clinic or to a brokerage case management model that linked patients to community-based services. Service use and clinical outcomes were collected at baseline, three months and six months post randomization on all participants. Access to and participation in mental health /substance abuse services was greater in the integrated model than in referral; there were no treatment by ethnicity effects. There were no treatment effects for any of the clinical outcomes; Whites and older minorities in both integrated and referral groups failed to show clinically significant improvement in symptoms and physical functioning at 6 months. While providing services in primary care results in better access to and use of these services, accessing these services is not enough for assuring adequate clinical outcomes.
SCIE Research briefing 41: factors that promote and hinder joint and integrated working between health and social care services
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, CAMERON Ailsa, LART Rachel, BOSTOCK Lisa, COOMBER Caroline
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2012
- Pagination:
- 24p.
- Place of publication:
- London
The research briefing focuses on jointly-organised services for older people and people with mental health problems in the UK only. It identifies different models of working between health and social care services at the strategic, commissioning and operational levels; evidence of effectiveness and cost-effectiveness; factors promoting and obstacles hindering the success of these models; and the perspectives of people who use services and their carers. The main issues are discussed under themes of: organisational issues; cultural and professional issues; and contextual issues. Gaps in the research evidence and the need to develop high-quality, large-scale research into joint and integrated working are also identified. The briefing updates a previous systematic review and excludes papers published before 2000.
Mental health services for older people towards an integrates approach
- Author:
- MIDDLETON Tony
- Journal article citation:
- Mental Health Review, 6(2), June 2001, pp.22-24.
- Publisher:
- Pier Professional
This article describes how Thurrock Council Social Services Department and South Essex Mental Health and Community Care NHS Trust launched a joint initiative to develop an integrated service strategy and implementation plan for older people's mental health services in Thurrock. The main principles of the approach were: service user and carer involvement, the active participation of mental health professionals working directly with service users and carers, representatives from all key agencies involved in the planning process.