title: Psychiatric assessment and screening for the elderly in primary care: design, implementation, and preliminary results.
abstract: BACKGROUND
  We describe the design and implementation of a psychiatric collaborative care model in a University-based geriatric primary care practice. Initial results of screening for anxiety and depression are reported.
  
  
  METHODS
  Screens for anxiety and depression were administered to practice patients. A mental health team, consisting of a psychiatrist, mental health nurse practitioner and social worker, identified patients who on review of screening and chart data warranted evaluation or treatment. Referrals for mental health interventions were directed to members of the mental health team, primary care physicians at the practice, or community providers.
  
  
  RESULTS
  Subjects (N=1505) comprised 38.2% of the 3940 unique patients seen at the practice during the 4-year study period. 37.1% (N=555) screened positive for depression, 26.9 % (N=405) for anxiety, and 322 (21.4%) screened positive for both. Any positive score was associated with age (p<0.033), female gender (p<0.006), and a non-significant trend toward living alone (p<0.095). 8.87% had suicidal thoughts.
  
  
  CONCLUSIONS
  Screening captured the most affectively symptomatic patients, including those with suicidal ideation, for intervention. The partnering of mental health professionals and primary care physicians offers a workable model for addressing the scarcity of expertise in geriatric psychiatry.
authors.affiliation: Department of Psychiatry and Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 140, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Abrams
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 39, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: Blanca
authors.initials: B
authors.lastname: Boné
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 39, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: M Cary
authors.initials: MC
authors.lastname: Reid
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 39, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Adelman
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 39, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: Risa
authors.initials: R
authors.lastname: Breckman
authors.affiliation: The Irving Sherwood Wright Center on Aging and Department of Nursing, New York Presbyterian Hospital, 1484 First Avenue, New York, NY 10075.
authors.forename: Ronald
authors.initials: R
authors.lastname: Goralewicz
authors.affiliation: The Irving Sherwood Wright Center on Aging and Department of Social Work, New York Presbyterian Hospital, 1484 First Avenue, New York, NY 10075.
authors.forename: Marlena
authors.initials: M
authors.lastname: Palombo
authors.affiliation: Weill Cornell Institute of Geriatric Psychiatry and Department of Social Work, New York Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605.
authors.forename: Amy
authors.initials: A
authors.lastname: Stern
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Box 39, New York Presbyterian Hospital, 525 East 68 St., New York, NY 10065.
authors.forename: Rouzi
authors.initials: R
authors.lastname: Shengelia
authors.affiliation: Research Division, Hebrew Home at Riverdale, New York; Stroud Center, Columbia University, New York State Psychiatric Institute; and Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College. Attn: Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teresi
keywords: Anxiety; Depression; Screening