Organization of old age psychiatric services

Banerjee, Sube; Chan, Jenifer

doi:10.1016/j.mppsy.2007.12.002

Cited by 17 publications

(18 citation statements)

References 20 publications

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“…Indeed, apart from a Health Advisory Service report in the mid 1990s (Health Advisory Service, 1997), in the UK policy for younger people with dementia is written into frameworks for older person's services (Department of Health, 2001). It is hoped that the Dementia Strategy in England will have an all-age focus (Banerjee & Chan, 2008). In 2006 in the United States, for the first time, the national office of the Alzheimer's Association publicly acknowledged the existence of this group of people by releasing a comprehensive report on the incidence, prevalence and special needs of people with early-onset dementia (Alzheimer's Association, 2006).…”

Section: Discussionmentioning

confidence: 99%

Selfhood in younger onset dementia: Transitions and testimonies

Harris

Keady

2009

Aging & Mental Health

153

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Younger people with dementia and their carers are an overlooked population for research, policy and practice attention. In this study, data were collected from both the United States and the UK in order to explore the meaning and construction of selfhood and identity. The US data collection included in-depth interviews with 23 people diagnosed with younger-onset dementia, while the UK data collection comprised 15 face-to-face interviews with younger carers of younger people with dementia; all carers were/had been caring for a younger person with dementia diagnosed through the DSM-IV-R criteria. A grounded theory analysis of the data resulted in the emergence of five themes to explain the interview data, these were: (1) identity as a worker; (2) identity of abandoned individual; (3) sexual identity; (4) family identity; and (5) identity as an individual engaged in living. Additional research is necessary to further develop the attributes and application of these identity profiles.

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Section: Discussionmentioning

confidence: 99%

Selfhood in younger onset dementia: Transitions and testimonies

Harris

Keady

2009

Aging & Mental Health

153

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“…Such divergence may, in part, be because of differences in the broader range of services available in different localities and is not necessarily of concern (Banerjee and Chan, ). In some (but not all) areas, for example, the existence of discrete memory services may at least partly explain the relative lack of patients with dementia with lower level needs, whilst the presence of comprehensive primary mental health services might account for a comparative lack of people with less complex depression in others.…”

Section: Discussionmentioning

confidence: 99%

Community mental health teams for older people: variations in case mix and service receipt (I)

Tucker

Wilberforce

Brand

et al. 2014

Int J Geriat Psychiatry

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Objectives: The study sought to identify the characteristics of community-dwelling older people supported by community mental health teams (CMHTs) in England and, in particular, to determine whether there is a common threshold for CMHT entry and/or a core client group. Methods: Data were collected about a random sample of 15 CMHTs' caseloads, including information about their sociodemographic characteristics, physical health, dependence, mental health, risks and service receipt. The sample was divided into 16 subgroups of people with similar needs for care (case types), and differences between teams were explored. Results: Information was obtained for 1396 patients. Just under half had a functional mental health problem, slightly over a third an organic disorder, seven per cent both, and nine per cent no diagnosis. Considerable variation was found in teams' caseloads, and there was no evidence of a common caseload threshold. Two of the commonest case types represented people with functional diagnoses who were independent in activities of daily living (ADL) and had no/low levels of challenging behaviour. Another representing people with organic/mixed diagnoses, ADL dependence, challenging behaviour and at least one medium risk was also fairly common. The two case types that represented patients with the most complex needs accounted for more than a quarter of some teams' caseloads but less than a tenth of others. Conclusions: It is wrong to assume that CMHTs all have similar caseloads. Commissioners must ensure that the network of services provided can meet the needs of all eligible patients, whilst more research is required on who such teams should target.

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“…Alternatively, it may be that the precise professional discipline of team members is less important than their particular skills and knowledge in determining their roles (Macdonald, ; Dening, ), although a third explanation might relate to a lack of consensus on professional boundaries. Whichever of these theories prevails, however, such variation is surely at least partly sustained by the lack of research in this area, with very little known about the different patient groups different professionals help most and where such specialist input should be focused (Philpot and Banerjee, ; Banerjee and Chan, ).…”

Section: Discussionmentioning

confidence: 99%

Community mental health teams for older people: variations in case mix and service receipt (II)

Wilberforce

Tucker

Brand

et al. 2014

Int J Geriat Psychiatry

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Objectives: To determine the extent to which services provided to older people via community mental health teams (CMHTs) vary in duration, composition and intensity. In particular, to identify the degree to which differences between teams are due to casemix. Methods: Data were collected about the services provided to a random sample of patients from 15 CMHT caseloads, including contact with CMHT staff, other specialist mental health and social care services. The relationship between patients' needs and service receipt was explored. Results: Information was obtained for 1396 patients. Average time on CMHT caseloads was 11.6 months, but there were marked between-team differences. The proportion of re-referrals also varied from under a tenth to over half. People with functional mental health problems and complex needs were most likely to be long-term CMHT clients. The proportion of patients seen by a consultant in the previous 6 months ranged from approximately a fifth to almost all. Differences with respect to contact with other qualified practitioners were less marked. Older people with functional disorders, challenging behaviour and at least one medium risk had the most regular contact with CMHT staff. Risk of self-harm, delusions and paranoia increased the likelihood of consultant involvement. Support workers were more likely to see people at risk of self-neglect. The receipt of other services, including day hospitals and inpatient care varied greatly. Conclusions: Considerable diversity was found in the length, nature and frequency of services provided to patients with different needs. Differences between teams were not wholly explained by case mix.

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Organization of old age psychiatric services

Cited by 17 publications

References 20 publications

Selfhood in younger onset dementia: Transitions and testimonies

Selfhood in younger onset dementia: Transitions and testimonies

Community mental health teams for older people: variations in case mix and service receipt (I)

Community mental health teams for older people: variations in case mix and service receipt (II)

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