New Zealand's psychiatry of old age services. Revisiting 'the view from the bottom of the cliff'--have we made any progress since 1998?
OBJECTIVE
In 1998, the New Zealand Branch of the Faculty of Psychiatry of Old Age (FPOA) surveyed psychiatry of old age (POA) services in New Zealand for their resource levels. At that time, they were low by international and Mental Health Commission 'Blueprint' levels. In 2003, POA services in New Zealand were resurveyed to determine how much progress had been made in the ensuing 5 years.


METHODS
All POA services in New Zealand who had Faculty members were surveyed for information on their service's administrative structure; access to acute, long stay and day hospital places; staffing levels of the different disciplines; the range of services they provided, and what they considered were strengths, gaps and potential improvements.


RESULTS
Thirteen services responded, providing services for 387,000 elderly people. Since 1998, acute bed numbers and day hospital places had proportionately decreased nationwide, with disparity of access across the country. Inpatient nursing staff had decreased by 34%, with community nurse numbers barely increasing. There were modest increases in the number of psychiatrists, junior doctors, clinical psychologists, and social workers.


CONCLUSIONS
There has been little progress towards achieving 'Mental Health Commission Blueprint' benchmark levels of service of 1998, and nationally there has been a decrease in access to acute beds, without a concomitant increase in staff to support older people in community settings.
Melding
Pamela S
PS
Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. p.melding@auckland.ac.nz
D000368:Aged; D002391:Catchment Area, Health; D003625:Data Collection; D005852:Geriatric Psychiatry / Q000639:trends; D006299:Health Services for the Aged / Q000600:supply & distribution* / Q000639:trends; D006280:Health Workforce / Q000706:statistics & numerical data* / Q000639:trends; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000600:supply & distribution* / Q000639:trends; D006801:Humans; D008605:Mental Health Services / Q000600:supply & distribution* / Q000639:trends; D009520:New Zealand