Psychogeriatric care in times of COVID. Lessons learned and proposals for similar situations.

The objective is to describe the problems related to outpatient psychogeriatric care in the context of the SARS-CoV-2 pandemic, as well as the proposed and implemented solutions for optimizing care for elderly people with mental disorders during the pandemic, that can also be applied in emerging similar situations in the future.

Coordinación de un servicio de Salud Mental con profesionales de Atención Primaria / Coordination of a Mental Health Service with Primary Care professionals

Objetivo: evaluar la opinión de los profesionales de Atención Primaria (AP) en relación con la coordinación y el funcionamiento de los servicios de Salud Mental ofrecidos por el Centro de Salud Mental Miraflores de Alcobendas (Madrid). Así mismo, se buscó determinar su formación autopercibida, el manejo del seguimiento y la derivación de casos y su valoración de las herramientas de coordinación. Método: estudio descriptivo transversal. Se incluyó a médicos y enfermeras de AP vinculados al Hospital Universitario Infanta Sofía de la Comunidad de Madrid (N= 344). Mediante cuestionario diseñado ad hoc se recogieron variables de formación, de relación terapéutica, de manejo de casos en AP y de relación con el servicio de Salud Mental medidas con escalas tipo Likert de 1 (mín.) a 5 puntos (máx.), sociodemográficas y laborales. Se realizaron índices de estadística descriptiva. Resultados: participaron 29 profesionales (25 médicos). Refirieron un 31% de consultas relacionadas con SM. Consideraron su formación como suficiente ( = 3,17/5) y que la derivación de casos a Salud Mental estaba condicionada por la ideación suicida ( =4,9/5) y la sintomatología grave ( =4,7/5). Los casos leves eran los más idóneos para atender en AP. Puntuaron la existencia de coordinación en 3,0/5. La herramienta considerada más útil fue la interconsulta por correo electrónico ( = 4,31/5) y las sesiones clínicas sobre casos solicitados por AP. Conclusión: la coordinación obtuvo una valoración positiva. Se detectaron condicionantes de la derivación sobre los que no se puede actuar directamente, pero otros susceptibles de abordarse con interconsultas o sesiones, herramientas bien valoradas por los profesionales.(AU)

Objective: to assess the opinion by Primary Care (PC) professionals regarding the coordination and functioning of the Mental Health services offered by the “Miraflores” Mental Health Centre in Alcobendas (Madrid). Also, to determine their self-perceived training, the management of follow-up and referral of cases, and their assessment of coordination tools. Method: a cross-sectional descriptive study, including PC doctors and nurses attached to the Hospital Universitario Infanta Sofía of the Community of Madrid (N= 344). Through a questionnaire designed ad hoc, the following variables were collected: training, therapeutic relationship, management of cases at PC and relationship with the Mental Health (MH) service measured through Likert-type scales from 1 (minimum) to 5 scores (maximum), as well as sociodemographic and occupational variables. Descriptive statistical indexes were conducted. Results: the study included 29 professionals (25 doctors), who referred 31% of consultations associated with MH. They considered their training as sufficient ( = 3.17/5), and referral to cases to MH was determined by suicidal ideation ( =4.9/5) and severe symptomatology ( = 4.7/5). Mild cases were the most adequate to be managed at PC. They gave a score of 3.0/5 to the current coordination. The tool considered most useful was consultation between professionals by email ( = 4,31/5), as well as clinical sessions about cases requested by PC. Conclusion: coordination achieved a positive evaluation. Some factors determining referral on which no direct action is possible were detected; but there are others that can be potentially addressed through consultations or sessions, which are tools positively valued by professionals.(AU)