Psychologists traditionally have not practiced within nursing homes, despite the rather high incidence of emotional and behavioral problems found within such settings. Recently, however, psychologists have been included in staffing guidelines written for nursing homes operated by the Veterans Administration (VA). In the present study, the nature and scope of psychological services provided within VA nursing facilities were surveyed so that the emerging professional domain of the nursing home psychologist could be delineated. Data regarding service delivery models, use of time, assessment and treatment services, multidisciplinary team activities, staff and student training, and research are provided. The profile of the "ideal" nursing home psychologist that emerges from this survey is that of a wellrounded psychologist capable of rendering a full range of assessment, treatment, and consultative services while also functioning as a treatment team member, a teacher, a program developer, and a researcher.It is widely recognized that the mental health needs of the elderly are vastly underserved. Kramer, Taube, and Redick (1973) estimated that approximately 80% of elderly persons who need mental health assistance fail to receive treatment. In addition, although adults over the age of 65 represent approximately 11% of the United States total population, they account for only 4% of those served each year by community mental health centers in this country (National Institute of Mental Health, 1978). This gap between the need for and the provision of mental health care will likely intensify over the coming years as the number of elderly adults in this country more than doubles, according to projections, by the year 2020 (Bouvier, 1976).Psychology, as a profession, has made a modest contribution toward satisfying the mental health demands of the elderly. Indeed, VandenBos, Stapp, and Kilburg (1981) found that only 2.7% of services delivered by health service provider psychologists went to clients 65 years of age or older. Unfavorable attitudes and stereotypes held by some clinicians regarding the aged (Gaitz, 1974) and the disinclination on the part of psychology training programs to THOMAS KUPKE received his doctorate in clinical psychology from the University of Georgia and completed a fellowship in clinical neuropsychology at Lafayette Clinic, Detroit, Michigan. He is currently a staff psychologist at the Venterans Administration Medical Center in Hampton, Virginia, where he directs the neuropsychology laboratory and the geropsychology program. Dr. Kupke holds adjunct faculty appointments at Eastern Virginia Medical School and the College of William and Mary. THE AUTHOR WISHES TO EXPRESS appreciation to the many Veterans Administration psychologists who participated in this survey. Computer support for this project was provided courtesy of
