title: A community development and outreach program in geriatric mental health: four years' experience.
abstract: OBJECTIVE
  To describe a geriatric mental health outreach program based on a community development model and to review 4 years of experience with this program.
  
  
  METHODS
  Program model and description of implementation experience.
  
  
  METHODS
  A geriatric mental health outreach program of a regional psychiatric hospital, serving a primarily non-urban area, with offices in the community it serves.
  
  
  METHODS
  The program targets community-dwelling or institutionalized older persons with late-onset mental health problems and/or behavioral disturbances, persons with long-standing psychiatric disorders with age-related changes, and their caregivers.
  
  
  METHODS
  The program is a geriatric mental health outreach and consultation service that emphasizes community development and caregiver education. Program components include an interprofessional consultation team, a specialized information and resource service, educational service initiatives, and an ongoing role in planning and coordination activity in the local health care system.
  
  
  METHODS
  Program monitoring, including a patient database and a description of program activities.
  
  
  RESULTS
  Cognitive impairment, behavioral disturbance, physical/medical problems and depression are the most common reasons for referral to the outreach program. Referred patients (mean age 78; 65% female) have usually (almost 90% of cases) been managed at a similar or lower level of care. Program activities have included focused educational initiatives in community and institutional settings and have emphasized the involvement and development of community caregivers and other local resources.
  
  
  CONCLUSIONS
  The program is a multifaceted effort to make efficient use of scarce specialized resources in a manner that is sensitive and responsive to local circumstances and needs. Experience to date has shown evidence of the feasibility and potential benefits of a comprehensive approach to community development and outreach in geriatric mental health.
authors.affiliation: Depatment of Psychiatry, McMaster Universtity, Hamilton, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Stolee
authors.forename: L
authors.initials: L
authors.lastname: Kessler
authors.forename: J K
authors.initials: JK
authors.lastname: Le Clair
mesh_terms: D000368:Aged; D002170:Canada; D003156:Community Mental Health Services / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D005852:Geriatric Psychiatry / Q000458:organization & administration*; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D017146:Models, Organizational; D009864:Ontario; D010043:Outcome and Process Assessment, Health Care; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation