How Many Nursing Home Residents Live With a Mental Illness?

Abstract

Policy makers and program managers need to be aware of the strengths and limitations of the data they use in order to make informed decisions. Users of the NNHS, MDS, and MAX data sets should be aware of the differences in recorded diagnoses among the three, especially the relatively limited diagnoses in the MAX and imprecise diagnoses in the MDS.

Mental Disorders Among Non-Elderly Nursing Home Residents

“…This finding is consistent with that of Mechanic and McAlpine (2000), who found a two-thirds reduction in the number of all nursing home residents younger than 65 with mental disorders between 1985 and 1995. Our estimate of residents younger than 65 with mental disorders is considerably lower than a previously reported estimate of 34.2% using 1999 MAX data and the same list of diagnoses (Bagchi et al, 2009). We attribute this difference to this study's emphasis on longstay residents (6 months or longer), whereas Bagchi et al used diagnoses from all long-term care claims in the last half of 1999, irrespective of length of stay.…”

“…We also excluded substance abuse disorders because our intention was specifically to focus on the population with mental disorders. To maintain consistency with prior studies of mental disorders using MAX data, we also excluded diagnoses of mental retardation (Bagchi et al, 2009). We included all other mental disorders corresponding to International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes ranging from 295 to 302 and from 306 to 314 drawn from the diagnoses fields of the MAX LTC, OT, and IP files.…”

“…Overall, about 13% of Medicaid-funded nursing home residents are between the ages of 21 and 64, with the majority of these residents (over three-quarters) between the ages of 45 and 64 (Bagchi, Verdier, & Simon, 2009). In the absence of appropriate community-based services and funding for those services, the predominantly near-elderly residents described in this paper will soon become elderly nursing home residents.…”

Successful Strategies for Discharging Medicaid Nursing Home Residents With Mental Health Diagnoses to the Community

“…While depression is one of the most common mental health diagnoses among NH residents (Bagchi, Verdier, & Simon, 2009) and does potentially impact NH discharge, depression was not included as a primary mental health diagnosis due to known concerns with the validity of the MDS depression measures (Simmons et al, 2004).…”

Psychiatric Disorders and Pain Treatment in Community Nursing Homes

“…Several studies indicate that dementia interferes with accurate assessment of nursing home residents’ pain (e.g., 8-12). However, with one exception (13), no one has considered whether the three other types of psychiatric disorder most prevalent in nursing homes [depression, serious mental illness, and substance use disorder (14-16)] also impact the quality of pain assessments obtained by nursing home residents.…”