Development of a tool to detect older adults with severe personality disorders for highly specialized care

ABSTRACTObjectives:Current guidelines recommend highly specialized care for patients with severe personality disorders (PDs). However, there is little knowledge about how to detect older patients with severe PDs. The aim of the current study was to develop an age-specific tool to detect older adults with severe PDs for highly specialized mental health care.Design:In a Delphi study, a tool to detect adults with severe PDs for highly specialized mental health care was adjusted for older adults based on expert opinion. Subsequently, the psychometric properties of the age-specific tool were evaluated.Setting:The psychometric part of the study was performed in two Dutch highly specialized centers for PDs in older adults.Participants:Patients (N = 90) from two highly specialized centers on PDs in older adults were enrolled.Measurements:The age-specific tool was evaluated using clinical judgment as the gold standard.Results:The Delphi study resulted in an age-specific tool, consisting of seven items to detect older adults with severe PDs for highly specialized mental health care. Psychometric properties of this tool were evaluated. Receiver operating curve analysis showed that the questionnaire was characterized by sufficient diagnostic accuracy. Internal consistency of the tool was sufficient and inter-rater reliability was moderate.Conclusions:An age-specific tool to detect older adults with severe PDs was developed based on expert opinion. Psychometric properties were evaluated showing sufficient diagnostic accuracy. The tool may preliminarily be used in mental health care to detect older adults with severe PDs to refer them to highly specialized care in an early phase.

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Children With ADHD Symptoms: Who Can Do Without Specialized Mental Health Care?

Journal of Attention Disorders ◽

10.1177/1087054718756194 ◽

2018 ◽

Vol 24 (1) ◽

pp. 104-112 ◽

Cited By ~ 1

Author(s):

Birgit Levelink ◽

Frans J. M. Feron ◽

Edward Dompeling ◽

Dorothea M. C. B. van Zeben-van de Aa

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Child Behavior Checklist ◽

Best Practice ◽

Rating Scales ◽

Adhd Symptoms ◽

Predictive Variables ◽

Specialized Care ◽

Specialized Mental Health

Objective: A new Dutch Child and Youth Act should reduce specialized mental health care for children with symptoms of ADHD. Characteristics of children referred to a specialized ADHD clinic are explored to give direction to this intention. Method: Data of 261 children who underwent a multidisciplinary best practice evaluation (including rating scales, and demographic, psychological, and somatic findings) were analyzed. Univariable and multivariable logistic regression models were used to find predictive variables for the need of specialized mental health care. Results: Collected data were heterogeneous. (Sub)clinical total scores on the Teacher Report Form (TRF) and Child Behavior Checklist (CBCL) were predictive variables for specialized mental health care. Also children with divorced parents were more often referred to specialized care. Conclusion: (Sub)clinical scores on the CBCL and TRF increased the need for specialized care, but comprehensive assessment of every child with ADHD symptoms was necessary to differentiate between levels of care.

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Psychometric Properties of the German Version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR)

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000105 ◽

2012 ◽

Vol 28 (4) ◽

pp. 255-261 ◽

Cited By ~ 5

Author(s):

Sabine Loos ◽

Reinhold Kilian ◽

Thomas Becker ◽

Birgit Janssen ◽

Harald Freyberger ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Community Mental Health ◽

Mental Health Care ◽

Psychometric Properties ◽

Therapeutic Relationship ◽

Internal Consistency ◽

Convergent Validity ◽

Community Mental Health Care ◽

German Version

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.

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Many Teens Considering Suicide Do Not Receive Specialized Mental Health Care

PsycEXTRA Dataset ◽

10.1037/e679482012-001 ◽

2012 ◽

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Specialized Mental Health

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Family involvement in mental health care for older adults: From caregiving to advocacy and empowerment.

Emerging issues in mental health and aging. ◽

10.1037/10179-008 ◽

1995 ◽

pp. 210-230 ◽

Cited By ~ 6

Author(s):

Roberta R. Greene

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Care ◽

Mental Health Care ◽

Family Involvement

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IMPACT OF PAIN INTERFERENCE ON TREATMENT OUTCOMES AMONG OLDER ADULTS WITH DEPRESSIVE AND ANXIETY SYMPTOMS RECEIVING COLLABORATIVE MENTAL HEALTH CARE

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2020.01.120 ◽

2020 ◽

Vol 28 (4) ◽

pp. S94-S95

Author(s):

Senthil Vel Rajan Rajaram Manoharan ◽

Arushi Kapoor ◽

Shahrzad Mavandadi ◽

Joel E. Streim

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Care ◽

Mental Health Care ◽

Treatment Outcomes ◽

Anxiety Symptoms ◽

Pain Interference ◽

Collaborative Mental Health Care

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Shifting to Remotely Delivered Mental Health Care: Quality Improvement in the COVID-19 Pandemic

Psychiatry International ◽

10.3390/psychiatryint1010005 ◽

2020 ◽

Vol 1 (1) ◽

pp. 31-35 ◽

Cited By ~ 1

Author(s):

Patrick Daigle ◽

Abraham Rudnick

Keyword(s):

Mental Health ◽

Health Care ◽

Quality Improvement ◽

Mental Health Care ◽

Health Care Quality ◽

Care Quality ◽

Health Clinic ◽

Quality Improvement Initiative ◽

Service Users ◽

Specialized Mental Health

This paper presents an organizational (ambulatory) case study of shifting mental health care from in-person to remote service delivery due to the current (COVID-19) pandemic as a rapid quality improvement initiative. Remotely delivered mental health care, particularly using synchronous video and phone, has been shown to be cost-effective, especially for rural service users. Our provincial specialized mental health clinic rapidly shifted to such remote delivery during the current pandemic. We report on processes and outputs of this rapid quality improvement initiative, which serves a purpose beyond pandemic circumstances, such as improving access to such specialized mental health care for rural and other service users at any time. In conclusion, shifting specialized mental health care from in-person to remotely delivered services as much as possible could be beneficial beyond the current pandemic. More research is needed to optimize the implementation of such a shift.

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