Heads in the sand may leave old age psychiatry looking foolish and vulnerable

Abstract

Dementia has been recognised as a major challenge to health, social care and economies. Research by Rubinsztein and colleagues, in this issue, has compared the services provided by memory clinics with those of traditional community mental health team services. They conclude that memory clinics offer a more comprehensive and multidisciplinary service at no extra cost. Here I will question some of their findings and highlight the importance of better continuity of care between primary and secondary services.

Effectiveness increases with integration in primary care

“…CMHTs provide follow-up for patients with dementia and behavioural and psychological symptoms of dementia in both service models David Jolley makes a valuable point about the need for ongoing support for patients receiving a dementia diagnosis and we agree that all patients deserve such input. 1 We disagree that our patients are failed by either the memory clinic combined with the community mental health team (CMHT) service or the traditional CMHT service described in our paper, 2 as both services have good relationships with general practitioners (GPs), who can refer rapidly into the CMHT arms of both services as any behavioural and psychological symptoms of dementia arise. Jolley criticises post-diagnostic signposting to the third sector as leaving patients and their relatives adrift.…”

“…It is good to read of the work of Dr de Silva and his colleagues in South Tyneside. 1 They are seeing people at an impressive hit rate and providing a service which people like. As in Gnosall, the model being used takes advantage of primary care settings.…”