Expanding the geriatric mental health workforce through utilization of non-licensed providers

被引：6

作者：

Kunik, Mark E. ^{[1
,2
,3
]}

Mills, Whitney L. ^{[1
,2
]}

Amspoker, Amber B. ^{[1
,2
]}

Cully, Jeffrey A. ^{[1
,2
,3
]}

Kraus-Schuman, Cynthia ^{[2
,4
]}

Stanley, Melinda ^{[1
,2
,3
]}

Wilson, Nancy L. ^{[1
,2
]}

机构：

[1] Michael E DeBakey VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Houston VA HSR&D Ctr Innovat Qual Effectiveness &, Houston, TX 77030 USA

[2] Baylor Coll Med, Dept Med, Houston, TX 77030 USA

[3] South Cent Mental Illness Res Educ & Clin Ctr, Houston, TX USA

[4] Michael E DeBakey VA Med Ctr, Mental Hlth Care Line, Houston, TX USA

来源：

AGING & MENTAL HEALTH | 2017年 / 21卷 / 09期

关键词：

Healthcare workforce; community health worker; mental health services; older adults; cognitive behavioral therapy; RANDOMIZED CONTROLLED-TRIAL; GENERALIZED ANXIETY DISORDER; COGNITIVE-BEHAVIOR THERAPY; SERVING OLDER-ADULTS; PRIMARY-CARE; COLLABORATIVE CARE; LAY PROVIDERS; DEMENTIA CARE; DEPRESSION; PARAPROFESSIONALS;

D O I：

10.1080/13607863.2016.1186150

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objectives: We evaluate policy and practice strategies for bolstering the geriatric mental healthcare workforce and describe costs and considerations of implementing one approach.Method: Narrative overview of the literature and policy retrieved from searches of databases, hand searches, and authoritative texts. We identified three proposed strategies to increase the geriatric mental healthcare workforce: (1) production of more geriatric mental health providers; (2) team-based care; and (3) non-licensed providers. We evaluate each in terms of challenges and potential and provide estimates of costs, policy, and practice considerations for training, employing, and supervising non-licensed mental health providers.Results: Use of non-licensed providers is key to reforms needed to allow a more older adults to access necessary mental healthcare. Licensed and non-licensed providers have achieved similar improvements for generalized anxiety disorder among patients, although non-licensed providers did so at a lower cost.Conclusion: Supervised non-licensed providers can extend the reach of licensed providers for specific mental health conditions, resulting in lower costs and increased number of patients treated. Although several barriers to implementation exist, policy and infrastructure changes that may support this type of care delivery model are emerging from reforms in financing and associated delivery initiatives created by the Affordable Care Act.

引用

页码：954 / 960

页数：7