MENTAL-HEALTH-SERVICES FOR THE ELDERLY LIVING IN THE COMMUNITY - UNITED-KINGDOM PERSPECTIVE

The main components of a psychogeriatric service with a preventive orientation were outlined as follows: 1. A number of medical and social arrangements in the community, comprising a network of domiciliary services, outpatient clinics designed to provide for the special problems of aged people, day hospitals, clubs offering facilities for people with differing needs, and aid to foster the growth of voluntary organizations or, in the words of the WHP Report, 'the spontaneous association of citizens for the purpose of bringing relief to those of their fellows in need.' The domiciliary services for the aged were conceived as providing meals-on-wheels, home visiting and nursing, transport to hospitals and clinics, laundry facilities, and mobile physiotherapy services. An administrative structure that would eliminate wasteful overlap, inefficiency, and inflexibility by facilitating the integration of the services of local health authorities, family doctors, and hospitals. 'Guidance centers' that would provide facilities for multidisciplinary investigation of the early phases of mental disorder and counseling. There is no single psychogeriatric program that combines all the components recommended in the WHO report. The development of such community-based psychogeriatric services, with an emphasis on early assessment and prevention, remains largely a challenge for the future.