Treatment of Late-Life Mental Disorders in Primary Care: We Can Do a Better Job

被引:9
作者
Moak, Gary S. [1 ]
机构
[1] Univ Massachusetts, Sch Med, Worcester, MA USA
关键词
collaborative care; geriatric psychiatry workforce; health care reform; late-life mental disorders; primary care; RANDOMIZED CONTROLLED-TRIAL; OLDER PATIENTS; COLLABORATIVE CARE; ELDERLY-PATIENTS; ALZHEIMERS-DISEASE; FAMILY PHYSICIANS; SUICIDAL IDEATION; DEPRESSION CARE; HEALTH-SERVICES; CLINICAL-TRIAL;
D O I
10.1080/08959420.2011.579503
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
Health care services provided to older adults today are not as effective as they should be. The quality of care for late-life mental disorders often falls short of desired standards. The growth of the elderly population makes it imperative for the health care system to address late-life mental disorders more effectively. Intervention strategies based in primary care settings show the most promise, but effectiveness will depend on solving the geriatric psychiatry workforce crisis. Collaborative care is one promising model for improving geriatric mental health care delivery in primary care. Diffusion of collaborative care into the health care system and integrating geriatric psychiatry into other models such as geriatric medical homes will require redesign of the organization and financing of primary care and psychiatry to overcome current barriers. Public policy should reflect the essential role of psychiatry in geriatrics and promote the integration of geriatric psychiatry with primary care.
引用
收藏
页码:274 / 285
页数:12
相关论文
共 45 条
[21]   Educational and organizational interventions to improve the management of depression in primary care - A systematic review [J].
Gilbody, S ;
Whitty, P ;
Grimshaw, J ;
Thomas, R .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (23) :3145-3151
[22]   Depression treatment preferences in older primary care patients [J].
Gum, AM ;
Areán, PA ;
Hunkeler, E ;
Tang, LQ ;
Katon, W ;
Hitchcock, P ;
Steffens, DC ;
Dickens, J ;
Unützer, J .
GERONTOLOGIST, 2006, 46 (01) :14-22
[23]   Training in geriatric mental health: Needs and strategies [J].
Halpain, MC ;
Harris, MJ ;
McClure, FS ;
Jeste, DV .
PSYCHIATRIC SERVICES, 1999, 50 (09) :1205-1208
[24]   Primary care physician office visits for depression by older Americans [J].
Harman, Jeffrey S. ;
Veazie, Peter J. ;
Lyness, Jeffrey M. .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2006, 21 (09) :926-930
[25]   Consensus statement on the upcoming crisis in geriatric mental health -: Research agenda for the next 2 decades [J].
Jeste, DV ;
Alexopoulos, GS ;
Bartels, SJ ;
Cummings, JL ;
Gallo, JJ ;
Gottlieb, GL ;
Halpain, MC ;
Palmer, BW ;
Patterson, TL ;
Reynolds, CF ;
Lebowitz, BD .
ARCHIVES OF GENERAL PSYCHIATRY, 1999, 56 (09) :848-853
[26]   Managing depressed and suicidal geriatric patients: Differences among primary care physicians [J].
Kaplan, MS ;
Adamek, ME ;
Calderon, A .
GERONTOLOGIST, 1999, 39 (04) :417-425
[27]   PRISM-E: Comparison of integrated care and enhanced specialty referral models in depression outcomes [J].
Krahn, DD ;
Bartels, SJ ;
Coakley, E ;
Oslin, DW ;
Chen, HT ;
McIntyre, J ;
Chung, H ;
Maxwell, J ;
Ware, J ;
Levkoff, SE .
PSYCHIATRIC SERVICES, 2006, 57 (07) :946-953
[28]   Management of Alzheimer's disease in a primary care setting [J].
Larson, EB .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 1998, 6 (02) :S34-S40
[29]   Suboptimal duration of antidepressant treatments in the older ambulatory population of Quebec: Association with selected physician characteristics [J].
Moride, Y ;
du Fort, GG ;
Monette, J ;
Ducruet, T ;
Boivin, JF ;
Champoux, N ;
Crott, R .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2002, 50 (08) :1365-1371
[30]   Emerging models of depression care: multi-level ('6 P') strategies [J].
Pincus, HA ;
Hough, L ;
Houtsinger, JK ;
Rollman, BL ;
Frank, RG .
INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, 2003, 12 (01) :54-63