title: Psychiatric services: experience, perceptions, and needs of nursing facility multidisciplinary leaders.
abstract: OBJECTIVE
  To identify the experience and perceptions of multidisciplinary nursing facility leaders regarding need for psychiatric services in residents of long-term care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Nursing facilities in Hawaii.
  
  
  METHODS
  Surveys were sent to 188 nursing facility administrators, medical directors, directors of nursing, and directors of social work at 47 facilities in Hawaii; 99 individual staff responses (52% response rate) were received from 42 facilities (89% response rate).
  
  
  METHODS
  Educational experience, psychiatric service perceptions, and needs as assessed by survey questions.
  
  
  RESULTS
  The most commonly cited reasons for not accepting a patient with a recent history of or current psychiatric or behavioral problems were concerns of dangerousness (73.5%), the need for greater staff attention (64.3%), and difficulty accessing psychiatric support and follow-up after admission (53.1%). Easy accessibility (66.3%) was the most essential consultant quality, and pharmacological treatment interventions (88.4%) were deemed most helpful. Behavioral management of dementia (93.6%) was the most requested educational topic, followed by depression and suicide (77.7%). There were some differences noted between specialties.
  
  
  CONCLUSIONS
  The findings highlight the unmet needs of nursing facility leaders, gives direction to and reinforces how psychiatrists, by virtue of their training and skills, can play a central role in meeting these needs, and offer a glimpse of the potential for collaboration to addresses the mental health and psychiatric service needs of the long-term care residents.
authors.affiliation: Department of Psychiatry, Tripler Army Medical Center, Honolulu, Hawaii, USA. russ.muramatsu@amedd.army.mil
authors.forename: Russ S
authors.initials: RS
authors.lastname: Muramatsu
authors.forename: Deborah
authors.initials: D
authors.lastname: Goebert
mesh_terms: D000288:Administrative Personnel; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006254:Hawaii; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008605:Mental Health Services; D020380:Needs Assessment; D009735:Nursing Homes