Linking level of care to level of need: Assessing the need for mental health care for nursing home residents.

Abstract Background Effectiveness and efficiency are part of the quality of care for mental health problems, and treatment should thus be performed at the right level of care. Norwegian guidelines specify which patients should be given priority for treatment in specialized mental health care (SMHC) centers, but there is a lack of agreement on which patients should actually receive SMHC. In this study we wanted to examine what factors (patient and GP characteristics) were related to GP patients who received treatment in SMHC centers. Methods In this retrospective cohort study, we looked at 12 months of data from electronic health records from six GP and SMHC centers of hospitals in the catchment area. We included all patients who had been treated at any of the GP centers during the 12-month period (N=18032). We fit a generalized linear mixed model to explore which factors were related to patients receiving treatment in SMHC centers. Further exploration was performed to study the effects of gender and contact frequency. Results We found that 4.6% of all GP patients and 18.4% of the GP patients with a mental health problems were treated in SMHC centers. There were more women than men among the GP-patients (56% vs 44%) and in SMHC centers (55% vs 45%), women with mental health problems were more severely ill than men. However, after adjusting for other factors men were more likely to be treated in SMHC centers (OR: 1.44). Patients with frequent GP contact were more likely to be treated in SMHC centers. The GP characteristics age, gender and specialization did not relate to patients receiving treatment in SMHC centers. Conclusions Men were more likely to be treated in SMHC centers than women, which may imply that they have different thresholds for entering SMHC centers. GP characteristics were not related to receiving treatment in SMHC centers. More specific knowledge is needed to determine whether men and women currently receive treatment at the lowest possible level of care.

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Characteristics of double care demanding patients in a mental health care setting and a nursing home setting: results from the SpeCIMeN study

Aging & Mental Health ◽

10.1080/13607863.2016.1202891 ◽

2016 ◽

Vol 22 (1) ◽

pp. 33-39 ◽

Cited By ~ 6

Author(s):

Janine Collet ◽

Marjolein E. de Vugt ◽

Frans R. J. Verhey ◽

Noud J. J. A. Engelen ◽

Jos M. G. A. Schols

Keyword(s):

Mental Health ◽

Health Care ◽

Nursing Home ◽

Mental Health Care ◽

Care Setting ◽

Health Care Setting ◽

Home Setting ◽

Nursing Home Setting

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A Tribute to the Late William J. Curran

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500004058 ◽

1996 ◽

Vol 24 (3) ◽

pp. 274-275

Author(s):

O. Lawrence ◽

J.D. Gostin

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

United Nations ◽

Mental Health Care ◽

Harvard University ◽

Legal Medicine ◽

General Assembly ◽

International Institute ◽

University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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