Mental health service delivery in long-term care homes.
BACKGROUND
The prevalence of mental disorders in long-term care (LTC) homes is high, but quality and availability of mental health services to assess and help in management of cases have been criticized.


METHODS
Literature concerning mental health problems in LTC homes was reviewed, especially regarding models of mental health service delivery and factors that affect development, persistence and reduction of symptoms and distress.


RESULTS
The advantages of consultation-liaison arrangements and of telepsychiatry were noted. Discussions led to development of recommendations aimed at improving mental health expertise and provision of assessment and intervention services in LTC homes in diverse countries. Prompt recognition of mental health problems among residents is required, with availability of a team working within the facility to deal with these problems. Commonly such multidisciplinary teams are formed by facility staff linking with visiting mental health professionals or services. Quality of care is also affected by the organization, attitudes and education within LTC facilities.


CONCLUSIONS
Provision of optimal mental health care in LTC settings is dependent on adequate funding, availability of expertise and education, positive and caring attitudes, recognition of needs, and supportive teamwork. The latter should include cooperative links between well-resourced and under-resourced regions.
Snowdon
John
J
Sydney Medical School, University of Sydney and Concord Hospital, Sydney South West Area Health Service, New South Wales, Australia. jsnowdon@mail.usyd.edu.au
D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000458:organization & administration*; D015577:Geriatric Assessment; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000458:organization & administration*; D006707:Homes for the Aged; D006801:Humans; D007373:Interinstitutional Relations; D008134:Long-Term Care; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D017146:Models, Organizational; D009735:Nursing Homes; D015995:Prevalence; D011787:Quality of Health Care