Improving mental health assessment and service planning practices for older adults: a controlled comparison study.
This study evaluated the effectiveness of a guided assessment and service planning intervention in improving the clinical practices of non-physician community mental health providers caring for older persons. Thirteen agencies, 44 clinicians, and 100 consumers (age 60 and older) were assigned to the intervention or a comparison group receiving usual care. Baseline interviews of clinicians and chart reviews found that clinicians' routine evaluation and service planning practices showed inattention to key domains such as substance abuse (over 33% of clinicians), suicide risk and dangerous behaviors (over 40%), and caregiver burden and risk of neglect or abuse (over 75%). At 1-year follow-up, the intervention was associated with increased rates of routine assessments of major symptom, functioning, and support domains. There was also significant improvement in the specificity of treatment planning within the intervention condition. Implications for quality improvement are discussed.
Bartels
Stephen J
SJ
New Hampshire-Dartmouth Psychiatric Research Center, New Hampshire, Lebanon. stephen.j.bartels@dartmouth.edu
Miles
Keith M
KM
Van Citters
Aricca D
AD
Forester
Brent P
BP
Cohen
Michael J
MJ
Xie
Haiyi
H
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003156:Community Mental Health Services / Q000592:standards*; D020000:Decision Support Systems, Clinical; D019033:Delivery of Health Care, Integrated; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D009511:New England; D010347:Patient Care Planning / Q000458:organization & administration / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D011795:Surveys and Questionnaires