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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)
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.
Purchasing power: getting the best for older people
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- Mental Health Today, November 2008, pp.26-29.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The authors discuss some of the challenges facing commissioners who are purchasing mental health services for older people. They briefly highlight some of the main complexities which include: the complexity of older people's identities; the make up of workforces; the difficult nature of work with older people; and the multiple agencies involved in working with older people. It is argued that consistent application of a long-term strategy, which allows the accumulation of small changes across agencies and disciplines, is likely to be the key to success. It sets out the issues that need to be addressed, the pitfalls to avoid, and examines a series of objectives for commissioners.
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.
Issues in mental health care for older adults after disasters
- Author:
- BROWN Lisa M.
- Journal article citation:
- Generations, 31(4), Winter 2007, pp.21-26.
- Publisher:
- American Society on Aging
This article describes key issues to consider when providing mental health care to older adults after a disaster. It covers strategies to assessment mental and medical health needs, provides an overview of interventions for use with older people during the recovery process, and identifies some of the challenges that might be encountered when providing services to older people across various settings.
Mental health in later life, a neglected area of policy and research allocation: summary of the UK Inquiry into Mental Health in Later Life
- Authors:
- HURST Philip, MINTER Jane
- Journal article citation:
- Housing Care and Support, 10(3), December 2007, pp.17-20.
- Publisher:
- Emerald
This article summarises the issues identified in the UK Inquiry report on Mental Health in Later Life. It looks at how the Inquiry undertook its work, how older people with mental health problems are often overlooked and what their views and experiences are of accessing services, what actions are proposed for the housing, health and care sectors, and key issues and recommendations.
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.
Improving mental health services for older people
- Author:
- HARION Nerys
- Journal article citation:
- Nursing Times, 21.08.07, 2007, pp.21-22.
- Publisher:
- Nursing Times
The UK Inquiry into Mental Health and Well-Being in later life has revealed that the care of older people with mental health problems is inadequate. The author outlines the some of the recommendations of the report and the five main priority areas for action.