A COMMUNITY-DEVELOPMENT AND OUTREACH PROGRAM IN GERIATRIC MENTAL-HEALTH - 4 YEARS EXPERIENCE

OBJECTIVES: To describe a geriatric mental health outreach program bas ed on a community development model and to review 4 years of experienc e with this program. DESIGN: Program model and description of implemen tation experience. SETTINGS: A geriatric mental health outreach progra m of a regional psychiatric hospital, serving a primarily non-urban ar ea, with offices in the community it serves. PARTICIPANTS: The program targets community-dwelling or institutionalized older persons with la te-onset mental health problems and/or behavioral disturbances, person s with long-standing psychiatric disorders with age-related changes, a nd their caregivers. INTERVENTION: The program is a geriatric mental h ealth outreach and consultation service that emphasizes community deve lopment and caregiver education. Program components include an interpr ofessional consultation team, a specialized information and resource s ervice, educational service initiatives, and an ongoing role in planni ng and coordination activity in the local health care system.MEASUREME NTS: Program monitoring, including a patient database and a descriptio n of program activities. RESULTS: Cognitive impairment, behavioral dis turbance, physical/medical problems and depression are the most common reasons for referral to the outreach program. Referred patients (mean age 78; 65% female) have usually (almost 90% of cases) been managed a t a similar or lower level of care. Program activities have included f ocused educational initiatives in community and institutional settings and have emphasized the involvement and development of community care givers and other local resources. CONCLUSION: The program is a multifa ceted effort to make efficient use of scarce specialized resources in a manner that is sensitive and responsive to local circumstances and n eeds. Experience to date has shown evidence of the feasibility and pot ential benefits of a comprehensive approach to community development a nd outreach in geriatric mental health.