Comparision of how old age psychiatry and general adult psychiatry services meet the needs of elderly people with functional mental illness: cross-sectional survey.

BACKGROUND: There is little research evidence as to whether general adult psychiatry or old age psychiatry should look after old people with enduring mental illness. AIMS: To compare the extent to which general adult and old age psychiatric services meet the needs of older people with enduring mental illness. METHOD: A total of 74 elderly patients with functional psychiatric disorders were identified by reviewing the notes of patients over the age of 60 living in a defined inner urban catchment area. Data were collected on the morbidity and needs of the sample. Needs were assessed using the Elderly Psychiatric Needs Schedule (EPNS). RESULTS: The participants in contact with old age psychiatry had significantly fewer unmet needs compared with those in contact with general adult psychiatry (2.8 v. 5.6, t = 2.2, P<0.03). Total needs were not significantly different between those managed by old age and general adult services (8.0 v. 6.5 respectively, t = 1.2, P = 0.2). CONCLUSIONS: This study found that old age psychiatry services were better placed to meet the needs of elderly people with mental illness. This finding supports the need for a separate old age psychiatry service.

An extra pair of hands? A case study of the introduction of support workers in community mental health teams for older adults.

BACKGROUND: Despite the expanding deployment of support workers in mental health services, little evidence exists on what managers and professional practitioners should expect of such staff in community settings. AIMS: This case study evaluated the introduction of support workers in community mental health teams for older adults. METHOD: A multiple method design engaged support workers and professional colleagues in individual interviews, a focus group and a work satisfaction survey. RESULTS: While the new resource boosted service provision, disparity between the intended role and the assumptions of professional practitioners caused confusion and dissatisfaction. CONCLUSIONS: The study highlights the need for managers to ensure role clarity when non-professional workers are introduced into multidisciplinary community teams. IMPLICATIONS FOR NURSING MANAGEMENT: Promoting diversity of skills in the mental health workforce is a progressive move in tuning services to the heterogenous needs of clients in the community. However, introducing unqualified workers into multi-disciplinary teams necessitates clear guidance to prevent their activity being confined within existing professional models. Support workers offer much potential in innovative service delivery.