|
||
The metrics of care and cost in Long Term Care facility operations relative to psychological health of residents Joseph M. Casciani, Ph.D. |
||
|
||
|
The purpose of this paper is threefold: (a) discuss the incidence of mental and behavioral disorders among nursing home residents, and some of the inherent difficulties in diagnosing these disorders in the older adult population; (b) review practice standards for mental health professionals and (c) outline the role of the mental and behavioral health practitioner in reducing health care utilization with the medically-ill population. History and Background The professional journals and research literature have repeatedly pointed out that mental and behavioral disorders are prominent among nursing home residents, that fewer than 5% of the residents with mental disorders received mental health services in a month, and that two-thirds of nursing home residents have a diagnosable mental illness... Barriers to Treatment Despite the high rates of depression and other mental disorders in nursing home residents, there are several reasons why these individuals do not receive the needed care... Nursing Home Reform Act of 1987 The Nursing Home Reform Act attempted to improve the quality of care in nursing homes, and imposed several requirements on nursing facilities. Within three years of OBRA, in 1990, Congress revised the Medicare laws to recognize mental health professionals as authorized providers of health care services. For the first time in the history of Medicare, beneficiaries were entitled to receive mental health care if necessary... Mental Health Practice Standards This section details the practice standards for clinical services, compliance with both the spirit and the letter of the Medicare program to insure that long term care residents will continue to receive quality mental health care, and discusses what can be expected from the mental health professional... Interplay between Mental Health and Physical Health An inseparability of mental and physical health problems with older adults is central to both the problem of the unmet need for services and the solution to mental and behavioral health service delivery… Medical Cost Offset There is considerable empirical support reflecting the unmet need for mental and behavioral health services with the older adult population. In recent years there has also been a proliferation of studies showing the medical cost offset of this care… Mental Health and Primary Care: Assuring Collaboration and Accountability With such a high incidence of mental disorders in the nursing home population, coupled with the impact of other costs when these disorders go undetected, it is in the best interests of the patient and the health care system when there is more collaboration between the mental health and the primary care systems. In the future, integrated, multidisciplinary care delivery in nursing facilities will become the standard of practice... Conclusion The points made in this paper are at the foundation of optimum care delivery to older adults. The benefits of mental and behavioral healthcare for older adults include not only improved quality of life and reduced care burdens for staff, but integrated care delivery with the primary care system, reduced health care utilization, and reduced health care costs… # # # The above is a synopsis of the paper entitled: A lateral survey of recent literature and observations on the unmet need for services, barriers to treatment and the interplay between mental health and physical health, based on the largest consistently administered geriatric mental and behavioral health program in the United States. Download entire article in pdf format Get Adobe Reader for pdf files |
||
|
Vericare (formerly Senior Psychology Services) is a national provider of mental and behavioral health services, primarily to long term care facilities. After twelve years, it has become the largest such service with over 1,000 client facilities. Vericare employs more than 300 psychologists, psychiatrists, social workers and other qualified professionals in eight states. Reprints of this monograph are available on request.
Contact us |
||
|
Vericare
- Article |
||
|
||