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Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay
- Authors:
- FINKEL Deborah, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(8), 2021, pp.1223-1230.
- Publisher:
- Wiley
Objectives: As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI. Methods: In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117). Results: After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced ‘re-institutionalization’ to another care setting, as opposed to living independently. Conclusions: The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life. (Edited publisher abstract)
A long time coming: part 2: achieving age equality in local mental health services
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2011
- Pagination:
- 52p.
- Place of publication:
- Bath
This document reports on the findings of the Achieving Age Equality in Mental Health Network. The Network ran from November 2010 to March 2011 and consisted of 4 different elements: development support to 2 localities based in the Midlands; a call for information on practical examples of age equality in mental health services; analysis of local and national data; and a review of concurrent national and development programmes. This document is the second of 2 reports arising from this work. It shares the experiences and lessons from the activities undertaken by the 2 Network sites, and the experiences of working in partnership to audit their mental health services, explore issues of discrimination and equality, and identify priority actions in order to address the identified age discrimination. The report outlines the practical steps that local health and social care communities can take to audit their services in order to identify where discrimination exists and what needs to happen in order to achieve age equality.
A long time coming: part 1: strategies for achieving age equality in mental health services
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2011
- Pagination:
- 27p.
- Place of publication:
- Bath
This document reports on the findings of the Achieving Age Equality in Mental Health Network. The Network ran from November 2010 to March 2011 and consisted of 4 different elements: development support to 2 localities based in the Midlands; a call for information on practical examples of age equality in mental health services; analysis of local and national data; and a review of concurrent national and development programmes. The development support provided to the 2 health and social care communities in the Midlands involved the audit of local mental health services to establish whether and where age discrimination exists and to identify priority actions for developing cost effective and inclusive mental health systems for all ages. This document is the first of 2 reports arising from this work. It focuses on the findings, key messages and priorities for achieving age equality. It identifies the critical issues that need urgent attention in order to eradicate age discrimination in mental health services everywhere. A central message is the need for much greater clarity and a shared understanding about age equality in respect of mental health and mental health services. The report sets out 4 priority actions identified by the Network that need to be taken forward at both a local and a national level.
Attitudes towards mental health services in Hispanic older adults: the role of misconceptions and personal beliefs
- Authors:
- JANG Yuri, et al
- Journal article citation:
- Community Mental Health Journal, 47(2), April 2011, pp.164-170.
- Publisher:
- Springer
Focusing on misconceptions and personal beliefs associated with depression, this study explored predictors of attitudes toward mental health services in a sample of 297 Hispanic older adults living in public housing in the USA. Results from a hierarchical regression analysis showed that negative attitudes towards mental health services were predicted by advanced age, belief that having depression would make family members disappointed, and belief that counselling brings too many bad feelings such as anger and sadness. Findings suggest that interventions designed to promote positive attitudes toward mental health services of older Hispanics should address misconceptions and personal beliefs.
Suicide ideation in older adults: relationship to mental health problems and service use
- Authors:
- CORNA Laurie M., CAIRNEY John, STREINER David L.
- Journal article citation:
- Gerontologist, 50(6), December 2010, pp.785-797.
- Publisher:
- Oxford University Press
The aim of this study was to assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2) for all adults aged 55 years and over was used to estimate the prevalence of suicide ideation and the prevalence of major psychiatric disorder and service use among ideators versus nonideators. Using multivariate models, the study considered the sociodemographic, social, and mental health correlates of suicide ideation and mental health care use. The results showed that more than 2% of older adults reported suicide ideation in the past year and more than two thirds of these respondents did not meet the criteria for any of the Diagnostic and Statistical Manual of Mental Disorders assessed in the CCHS 1.2. In multivariate models, being male, younger, or widowed, reporting lower social support and higher psychological distress increased the likelihood of suicide ideation. More than 50% of the respondents who reported suicidal thoughts did not access any type of mental health care use. The article concludes that, although suicide ideation is associated with depression and anxiety disorders, many older adults with suicidal thoughts do not meet the criteria for these clinical disorders.
Access to public mental health services among older adults with severe mental illness
- Authors:
- GILMER Todd P., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(3), March 2009, pp.313-318.
- Publisher:
- Wiley
Data from San Diego County, 2002-2006, were used to examine how older adults initially accessed the public mental health system, and their utilization over the subsequent 90 days. Multivariate regression models were used to control for demographic and clinical characteristics. Older adults (age 60 +) were more likely to access the public mental health system through the Psychiatric Emergency Response Team (PERT), a combined law-enforcement and psychiatric service that responds to psychiatric related 911 calls. Older adults were also less likely to receive follow-up care. This lower rate of follow-up was due to both the initial site of service - and an associated lower rate of follow-up among PERT clients - as well as a lower rate of follow-up among older adult clients initiating services in other sectors. This paper suggests two areas for intervention that would improve access to care for older adults: improving linkages and referrals between PERT and outpatient providers; and additional efforts to retain older adults at outpatient programs.
Age equality: what does it mean for older people's mental health services?
- Author:
- CARE SERVICES IMPROVEMENT PARTNERSHIP. National Older People's Mental Health Programme
- Publisher:
- Care Services Improvement Partnership. National Older People's Mental Health Programme
- Publication year:
- 2008
- Pagination:
- 4p.
- Place of publication:
- London
A 4-page report on older people's mental health services: Providing age inclusive services is an issue currently hotly debated across the country. In some cases it is even slowing progress in the implementation of Everybody's Business. This short paper attempts to clarify what is meant by service provision based on need not age.
How bias starts at 65
- Author:
- LISHMAN Gordon
- Journal article citation:
- Community Care, 30.08.07, 2007, pp.30-31.
- Publisher:
- Reed Business Information
The author examines findings from the recent report, UK Inquiry in Mental Health and Well-Being in Later Life', on older people's experience of mental health services. The findings indicate that a lot needs to be done before age discrimination is eradicated.
The relationship of religiosity to older adults’ mental health service use
- Author:
- PICKARD J. G.
- Journal article citation:
- Aging and Mental Health, 10(3), May 2006, pp.290-297.
- Publisher:
- Taylor and Francis
This article uses data from the Naturally Occurring Retirement Community (NORC) Demonstration Project (N=326) to examine older adults’ utilization of mental health services. This study is guided by the behavioral model of health service utilization and helps to fill gaps in the literature by including religious affiliation, religiosity, and interaction terms as variables in regression models. These variables are important, as religion is more important in the lives of older adults than in the lives of their younger counterparts. This study found the rate of use of mental health services during the previous six months to be 19.0%, and those with higher levels of private religious activity and higher levels of intrinsic religiosity are more likely to have accessed some form of mental health service. However, frequency of attendance at religious services is not associated with the use or non-use of services. Information from this study suggests that more research is needed to specify the manner in which religious affiliation and religiosity work to affect the use of mental health services, and future studies must include religious variables in order for models of service use to be complete.
Losing time: developing mental health services for older people in Wales
- Author:
- AUDIT COMMISSION
- Publisher:
- Audit Commission
- Publication year:
- 2002
- Pagination:
- 42p.
- Place of publication:
- London
The quality of mental health services for older people in Wales varies greatly depending on where they live, and there are severe shortages of specialist care when they can no longer be supported at home. Carers are generally well supported but their needs should be assessed more consistently and staff in residential homes need better training. Report highlights over 30 examples of good practice, but says that this needs to be shared more widely. Calls for more partnership working between health and social care and the introduction of defined minimum standards.