Search results for ‘Subject term:"severe mental health problems"’ Sort:
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A creative reminiscence program for older adults with severe mental disorders: results of a pilot evaluation
- Author:
- WILLMESE Bernadette M.
- Journal article citation:
- Aging and Mental Health, 13(5), September 2009, pp.736-743.
- Publisher:
- Taylor and Francis
Older adults with severe mental disorders can experience major dissatisfaction with conditions of life that are connected with ageing. To assist them in developing a coherent, meaningful life-story and to improve their life satisfaction, a pilot evaluation of a creative reminiscence program called Searching for meaning in life was conducted. One week before and one week after the intervention 36 participants from three psychiatric hospitals and one sheltered housing program in the Netherlands were interviewed. Life satisfaction was measured with the Manchester Short Assessment of Quality of Life (MANSA) and the Philadelphia Geriatric Center Moral Scale (PGCMS). At follow-up questions were also asked about the intervention. About 78% of the participants completed the course. Most of them were satisfied with the course (74%). The overall sample showed significantly more life satisfaction after the intervention. Participants with a psychotic disorder also improved significantly in life satisfaction but at the same time their depressive symptoms increased significantly. Participants with a moderate to high level of depressive symptoms at baseline had relatively favourable outcomes. Their life satisfaction had improved significantly and they especially had a better attitude toward their ageing. 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.
Older people with enduring mental illness: a needs assessment tool
- Authors:
- ABDUL-HAMID Walid K., et al
- Journal article citation:
- Psychiatric Bulletin, 33(3), March 2009, pp.91-95.
- Publisher:
- Royal College of Psychiatrists
There is a lack of tools to assess the needs of older people with enduring mental illness who have ‘graduated’ from adult mental health services and little is known about this population. The Elderly Psychiatric Needs Schedule (EPNS) was developed and applied to older people with enduring mental illness in contact with the old age and general adult components of an inner-city mental health service. The EPNS proved reliable. The mean number of needs identified was 7.6, of which 4.3 were unmet and 3.3 were met. It is concluded that the EPNS provided a reliable method of needs assessment in this population. The authors offer the EPNS as a tool to assess service needs of older adults with functional psychiatric disorders having ‘graduated’ from adult mental health services.
Perceptions of biopsychosocial services needs among older adults with severe mental illness: met and unmet needs
- Authors:
- CUMMINGS Sherry M., CASSIE Kimberly McClure
- Journal article citation:
- Health and Social Work, 33(2), May 2008, pp.133-143.
- Publisher:
- Oxford University Press
This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health centre in a large southern American city to participate in the study. The typical client experienced a need for care in 10 areas, with the greatest needs occurring in the areas of psychological pain, physical illness, social contacts, looking after the home, and daily activities. The total number of unmet needs ranged from zero to 10, with the typical client having an average of 2.3 unmet needs (SD = 2.4). The highest proportions of unmet needs were in the areas of social contact, benefits, sight or hearing difficulties, and intimate relationships. Linear hierarchical regression analyses revealed that clients with lower income, greater impairments in independent daily living skills, and higher levels of depression experienced increased needs for care. Older clients who lived in private homes or apartments had higher levels of depression, and those who required assistance in the areas of intimate relationships and benefits experienced higher levels of unmet needs. Research and practice implications are discussed.
Caregivers of older clients with severe mental illness: perceptions of burdens and rewards
- Authors:
- CUMMINGS Sherry M., MacNEIL Gordon
- Journal article citation:
- Families in Society, 89(1), January 2008, pp.51-60.
- Publisher:
- The Alliance for Children and Families
Approximately 1 million older persons have a severe mental illness (SMI) and this number is expected to double in the coming decades. While research studies have examined the experiences of family members of younger persons with SMI, very little is known about caregivers of older SMI clients. This study examined the characteristics, burdens, and rewards of 60 caregivers of older SMI clients in the US using a modified version of family caregiver scales of Tessler, Fisher, & Gamache (1992). Hierarchical linear regression analyses indicated that increased client symptoms, higher levels of help provided, increased caregiver income, and knowledge about the care recipient’s diagnosis were predicative of caregiver burden. Decreased number of client symptoms, care recipient being female, and greater experience of the presence of God predicted caregiver rewards. Implications of these findings are discussed.
Dementia and the law in England and Wales
- Author:
- LUTTRELL S.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(8), August 2000, pp.766-769.
- Publisher:
- Wiley
Looks at mental health legislation in relation to mentally incapable adults, including the case of R v Bournewood NHS Trust. Argues that it is now time to create legislation for mental health which combines both the common law's autonomy and the protection given by mental health legislation.
Predictors of psychiatric re-hospitalization in older adults with severe mental illness
- Authors:
- YU Ching, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(11), 2015, pp.1114-1119.
- Publisher:
- Wiley
Objective: To identify predictors of psychiatric re-hospitalization for patients with severe recurrent mental illness who are approaching late life. Methods: This was a retrospective cohort study of all 226 geriatric patients (age ≥65 years) admitted to a tertiary care Canadian inpatient psychiatric unit between 2003 and 2008. The main outcome was psychiatric re-hospitalisation in 5-year follow-up post-discharge (e.g. 2008–2013 if a patient had been first admitted in 2008). Multivariate Cox regression analyses were used to identify potential predictors of re-hospitalization. Results: Over 5-year follow-up, 32.3% (73/226) required psychiatric re-hospitalisation. Prior lifetime history of psychiatric admission, currently living in a supervised setting and bipolar disorder diagnosis all independently predicted a lower time to psychiatric re-hospitalisation. Conclusions: The rate of psychiatric re-hospitalisation is high in older adults admitted for severe mental illness. Clinicians should be aware of the especially high rates of re-hospitalisation in geriatric psychiatric inpatients with bipolar disorder, previous psychiatric admissions, or those living in a supervised setting. Future research could investigate approaches to prevent psychiatric re-hospitalisation in these vulnerable sub-populations. (Edited publisher abstract)
Prevalence and incidence of delirium in long-term care
- Authors:
- McCUSKER Jane, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(11), November 2011, pp.1152-1161.
- Publisher:
- Wiley
The identification of delirium is important as it is potentially reversible. Most studies of the epidemiology of delirium have taken place in acute settings; those in long term care facilities often have methodological limitations. This study examined the prevalence and 6-month incidence of delirium in seven long-term care facilities (LTCF) in the province of Quebec. It also describes differences in these measures by resident baseline characteristics. Participants aged 65 and over were recruited into two cohorts: A with a Mini-Mental State Examination (MMSE) score of 10 or more (n=209) and B with a score of less than 10 (n=75). Baseline measurements were gathered from research resident assessments, nurse interviews, and chart review. Weekly assessments for up to 24 weeks included the Confusion Assessment Method (CAM). The prevalence of delirium at baseline was 3.4% in Cohort A and 33.3% in Cohort B. The incidence of delirium among those without delirium at baseline (per 100 person-weeks of follow-up) was 1.6 in Cohort A and 6.9 in Cohort B. In multivariate analyses, a diagnosis of dementia, moderate to severe cognitive impairment, and depressive symptoms at baseline were associated with a greater prevalence and incidence of delirium. The authors conclude that delirium is a significant clinical problem in LTCF residents, particularly among those with moderate to severe cognitive impairment at baseline.
A survey of older adult patients in special secure psychiatric care in Scotland from 1998 to 2007
- Authors:
- LIGHTBODY Elizabeth, GOW Rona L., GIBB Robert
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 21(6), December 2010, pp.966-974.
- Publisher:
- Taylor and Francis
One area in which the needs of older adults may not be being met is in the field of forensic psychiatry. The aim of this survey was to gather information about the number and the needs of older adult patients in special secure forensic psychiatry care in Scotland. Inpatients of The State Hospital, Carstairs aged 55 or over throughout a 10-year period were included. Thirty-six patients were identified: 22 reached the age of 55 during their admission, and 14 were new admissions after the age of 55. This population has heterogeneous and complex needs. The most common diagnoses are of psychotic illnesses. Most patients are admitted from other secure psychiatric facilities or prison and the duration of admission is long. There are high rates of physical illness, mobility impairment, sensory impairment and polypharmacy. Offences tend to be at the severe end of the spectrum, including homicide, sexual offences and other violent offences. Most patients are single males and socioeconomic classes IV and V are over-represented. The article concludes that, given the complex needs of older mentally disordered offenders, their management would benefit from old age and forensic mental health services jointly working together.
Significance of spirituality in the lives of older adults with and without serious mental illness
- Author:
- FOW Dori S.
- Journal article citation:
- Social Work in Mental Health, 8(5), September 2010, pp.469-481.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper first presents an international literature review. It then assesses a convenience sample study of 41 volunteer, older adults, aged 55 years and older, already in a Programme of All-Inclusive Care for the Elderly, to examine whether spirituality is linked to severe mental health problems, such as bipolar disorder, schizophrenia or schizoaffective disorder. No statistically significant differences were shown between groups with and without mental health problems. However, the study did underline the importance of some aspects of spirituality to the quality of life of participants. The author stresses the importance of understanding the role of spirituality in each individual client’s life, and champions for this type of assessment to be incorporated in future standards of care which will lead to better outcomes and for further research.