The needs of rural and urban young, middle-aged and older adults with a serious mental illness.
OBJECTIVE
The delivery of mental health services is often provided through agencies set up to serve both young and older adults. Young and older adults with a severe mental illness (SMI) have different needs; this study was designed to identify important differences.


METHODS
This is a descriptive study based on a representative sample of mental health services users from northwestern Ontario (n = 532 [one-half rural and one-half urban]). The service provider most familiar with each user completed a questionnaire. We compared the characteristics and needs of users aged 18-29, 30-59 and 60 years and older.


RESULTS
The results showed that a greater proportion of individuals in the older group (55.3%) had physical comorbidities, compared with people in the younger and middle-aged groups (30.3% and 45.2%, respectively; p = 0.004), and more people in the older group used psychotropic medications (83.0% v. 62.9% and 75.5%, respectively; p = 0.006). Although the level of need was great for all age groups, the older group had greater need for medication management, physical health care, self-care and other activities of daily living (p < 0.05). A greater need for support was also identified for the family of older adults (p = 0.005). A lesser need was identified for psychotherapy or counselling, vocational training, and correction, probation or parole matters (p < 0.05).


CONCLUSIONS
We identified important differences in the needs of young, middle-aged and older people with an SMI. Addressing the needs of the older adults assumes a system that is responsive to their particular situations. Further work to ensure that the treatment of older adults reflects these differences and is based on best practices should be conducted.
Public Health Program, Lakehead University, St. Joseph's Care Group, Division of Human Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Michel
M
Bédard
Carrie
C
Gibbons
Sacha
S
Dubois
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D019037:Urban Health Services / Q000706:statistics & numerical data*