scholarly journals Prevalence of Mental Illness and its Impact on the Use of Home Care and Nursing Homes: A Population-Based Study of Older Adults in Manitoba

2007 ◽  
Vol 52 (9) ◽  
pp. 581-590 ◽  
Author(s):  
Patricia J Martens ◽  
Randall Fransoo ◽  
Elaine Burland ◽  
Charles Burchill ◽  
Heather J Prior ◽  
...  

Objectives: To determine the prevalence of mental illness in older adults and its effect on home care and personal care home (PCH) use. Methods: Using nonidentifying administrative records (fiscal years 1997–1998 to 2001–2002) from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy, we determined the 5-year period prevalence for individuals aged 55 years and over (119 539 men and 145 752 women) for 3 mental illness categories: cumulative mental disorders (those having a diagnosis of depression, anxiety disorder, personality disorder, schizophrenia, and [or] substance abuse), any mental illness, and dementia. We calculated age-specific and age-adjusted rates of home care and PCH use and the prevalence of mental illness in PCH residents. Results: From the group aged 55 to 59 years to the group aged 90 years or older, the prevalence of mental illness increased with the population's age. The prevalence of any mental illness rose from 32.4% to 45.0% in men and from 42.6% to 51.9% in women, and dementia prevalence rose from 2.0% to 33.6% in men and from 1.3% to 40.3% in women. The age-adjusted annual rates of open home care cases per 1000 population aged 55 and older varied by mental illness grouping (no mental disorder, 57 for men and 91 for women; cumulative mental disorders, 162 for men and 191 for women; dementia, 300 for men and 338 for women). The age-adjusted rates of PCH use per 1000 population aged 75 years and older also varied by mental illness grouping (no mental disorder, 53 for men and 78 for women; cumulative mental disorders, 305 for men and 373 for women; dementia, 542 for men and 669 for women). Among patients admitted to (or resident in) a PCH in 2002–2003, 74.6% (87.1%) had a mental illness, and 46.0% (69.0%) had dementia. Conclusions: Mental illness affects the use of home care and nursing homes profoundly. Individuals with dementia used home care at 3 times the rate of those having no mental illness diagnosis, and they used PCHs at 8 times the rate. Objectifs: Déterminer la prévalence de la maladie mentale chez les personnes âgées et son effet sur l'utilisation des soins à domicile et des foyers de soins personnels (FSP). Méthodes: À l'aide des dossiers administratifs anonymes (exercices financiers 1997–1998 à 2001–2002) du dépôt de données de recherche sur la santé de la population du centre de politiques en santé du Manitoba, nous avons déterminé la prévalence sur 5 ans, pour les personnes de 55 ans et plus (119 539 hommes, 145 752 femmes), de 3 catégories de maladie mentale: les troubles mentaux cumulatifs (ceux qui ont un diagnostic de dépression, de trouble anxieux, de trouble de la personnalité, de schizophrénie, et [ou] d'abus de substance), toute maladie mentale, et la démence. Nous avons calculé les taux par âge et les taux rectifiés selon l'âge d'utilisation des soins à domicile et des FSP ainsi que la prévalence de la maladie mentale chez les résidents des FSP. Résultats: La prévalence de la maladie mentale augmentait avec l'âge de la population, depuis le groupe des 55 à 59 ans jusqu'au groupe des 90 ans et plus. La prévalence de toute maladie mentale passait de 32,4 % à 45,0 % chez les hommes et de 42,6 % à 51,9 % chez les femmes, et la prévalence de la démence passait de 2,0 % à 33,6 % chez les hommes, et de 1,3 % à 40,3 % chez les femmes. Les taux annuels rectifiées selon l'âge des cas ouverts de soins à domicile par tranche de 1 000 de population de 55 ans et plus variaient selon le regroupement de maladies mentales (aucun trouble mental, 57 pour les hommes et 91 pour les femmes; troubles mentaux cumulatifs, 162 pour les hommes et 191 pour les femmes; démence, 300 pour les hommes et 338 pour les femmes). Les taux rectifiées selon l'âge d'utilisation des FSP par tranche de 1 000 de population de 75 ans et plus variaient aussi selon le regroupement de maladies mentales (aucun trouble mental, 53 pour les hommes et 78 pour les femmes; troubles mentaux cumulatifs, 305 pour les hommes et 373 pour les femmes; démence, 542 pour les hommes et 699 pour les femmes). Parmi les patients hospitalisés (ou résidents) des FSP en 2002–2003, 74,6 % (87,1 %) avaient une maladie mentale, et 46,0 % (69,0 %) souffraient de démence. Conclusions: La maladie mentale affecte profondément l'utilisation des soins à domicile et des établissements de soins prolongés. Les sujets souffrant de démence utilisaient les soins à domicile à 3 fois le taux de ceux qui n'avaient pas de diagnostic de maladie mentale, et les FPS, à 8 fois le taux des personnes sans diagnostic.

2011 ◽  
Vol 31 (2) ◽  
pp. 57-66
Author(s):  
AD Foebel ◽  
JP Hirdes ◽  
GA Heckman ◽  
SL Tyas ◽  
EY Tjam

Introduction Le vieillissement de la population canadienne s’accompagne d’un accroissement du fardeau que représente l’insuffisance cardiaque (IC), affection associée à un taux de morbidité et de mortalité important ainsi qu’à un recours fréquent aux services de santé. Méthodologie Nous avons extrait les données de la base de données du Resident Assessment Instrument-Home Care (RAI-HC) de l’Ontario pour tous les clients bénéficiant de soins à domicile de longue durée et âgés de 65 ans et plus, afin 1) de décrire les caractéristiques démographiques et cliniques des clients de soins à domicile souffrant d’insuffisance cardiaque et 2) d’examiner le recours aux services de santé par les clients de soins à domicile souffrant d’insuffisance cardiaque. Résultats Par rapport aux autres clients de soins à domicile, ceux qui souffrent d’insuffisance cardiaque présentent un état de santé plus instable, consomment davantage de médicaments, affichent un taux plus élevé de comorbidité et ont besoin d’un volume significativement plus élevé de soins infirmiers, ainsi que de services ménagers et culinaires. Ils sont hospitalisés plus fréquemment et font un usage significativement plus élevé des services d’urgence et des soins de première urgence. Analyse Les clients souffrant d’insuffisance cardiaque constituent un groupe plus complexe que les clients des soins à domicile en général. La manière dont les patients prennent en main leur santé doit être adaptée à leurs caractéristiques cliniques, à leurs schémas habituels d’utilisation des services et aux obstacles auxquels ils doivent faire face. Ce constat est particulièrement vrai chez les patients plus âgés, frêles et au profil médical complexe qui souffrent d’insuffisance cardiaque, et ils sont nombreux parmi ceux qui requièrent des services à domicile. Cette étude peut servir d’assise à des initiatives de base permettant d’aider ces clients aux besoins particulièrement grands à gérer leur insuffisance cardiaque à domicile grâce à de l’aide et à des services adaptés.


2017 ◽  
Vol 52 (6) ◽  
pp. 530-541 ◽  
Author(s):  
Melissa J Green ◽  
Stacy Tzoumakis ◽  
Kristin R Laurens ◽  
Kimberlie Dean ◽  
Maina Kariuki ◽  
...  

Objective: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. Methods: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census–defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. Results: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ ( N = 4368; 6.5%); (2) ‘pervasive risk’ ( N = 2668; 4.0%); (3) ‘mild generalised risk’ ( N = 7822; 11.6%); and (4) ‘no risk’ ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. Conclusion: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.


2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.


Author(s):  
Lisa Nicole Sharwood ◽  
Taneal Wiseman ◽  
Emma Tseris ◽  
Kate Curtis ◽  
Bharat Vaikuntam ◽  
...  

IntroductionRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management, and cost of this often complex comorbid health profile is not sufficiently understood. Objectives and ApproachIn a whole-population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders, and compare differences in injury epidemiology, costs and inpatient allied health service access. Record-linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific ICD-10-AM codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. Results13,489 individuals sustained acute TSI during this study. 13.11%, 6.06%, and 1.82% had pre-existing mental illness, substance use disorder, and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared to individuals without mental disorder (p<0.001). Conclusion / ImplicationsIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared to individuals without mental disorder. Care pathway optimisation including prevention of hospital acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.


2003 ◽  
Vol 37 (6) ◽  
pp. 728-734 ◽  
Author(s):  
Alexander I. F. Simpson ◽  
Philip M. Brinded ◽  
Nigel Fairley ◽  
Tannis M. Laidlaw ◽  
Fiona Malcolm

Objective: The National Study on Psychiatric Morbidity in New Zealand Prisons identified undiagnosed mental illness and unmet treatment needs for mentally disordered offenders. As approximately 50% of prisoners are of Maori and 8.3% Pacific Island ethnicity, we analyzed the data to determine if there were any differences in the rates of major mental disorders between ethnic groups. Method: A census of all female prisoners, all remand male prisoners and an 18% random sample of the sentenced male prisoners were interviewed employing the diagnostic interview for mental illness (CIDI-A), screening diagnostic interview for relevant personality disorders (PDQ) and suicide screening questions. Self-identified ethnicity was recorded. Ethnic groups were compared for sociodemographic variables, morbidity for mental disorder, treatment experience and suicidality. Results: The ethnic groups were largely similar in age and current prevalence for mental disorders, although there was some evidence of differing sociodemographic factors, especially younger age among the Maori prisoners. Maori report fewer suicidal thoughts, but acted suicidally at the same rate as non-Maori. Treatment for mental disorder was less common among Maori and Pacific Island prisoners than others, both in prison and in the community. Conclusion: Criminogenic factors present in the developmental histories of prisoners might also increase the risk of mental disorders. Ethnic groups were not different in the rate at which they manifest mental disorders in the face of such factors. Younger prisoners were disproportionately more likely to be of Maori or Pacific Island ethnicity. Both prior to and after entry to prison, services must improve responsiveness to Maori and Pacific Island people.


Criminologie ◽  
2005 ◽  
Vol 28 (2) ◽  
pp. 61-83 ◽  
Author(s):  
Danielle Laberge ◽  
Daphné Morin ◽  
Marie Robert

This article discusses how pre-trial detention has become an important instrument in the treatment of the accused whose mental state has been questioned during the judicial process. This study is part of a major research trend centered on the hypothesis of criminalization of the mental illness. This hypothesis has been defined as a shift of groups of the population from the mental health system to the criminal justice system. First, the authors examine how the Criminal Code's dispositions and those regarding mental disorder, which have been revised in February 1992, can be associated with the Court's decisions regarding the release of the accused during the legal process. Then, the authors continue to look into the question concerning the articulation of dual decisional logic (judicial and psychiatric) by studying approximately 1 000 cases heard before the Criminal and Penal Chamber of the Québec Court in Montréal in 1992-1993, in which the mental illness issue was raised. This analysis will try to demonstrate a link between pre-trial detention and mental health problems. It will also show that, despite the adoption of the principle of presumption against custody during assessment orders regarding mental disorder, the Court practices are changing slowly and the new dispositions are rarely used.


Author(s):  
Sarah Ashworth ◽  
Krista Jansen ◽  
Lydia Bullock ◽  
Paul Mooney

Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.


2015 ◽  
Vol 16 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Cindy L. Marihart ◽  
Ardith R. Brunt ◽  
Angela A. Geraci

This article provides a commentary on the costs of obese nursing home patients. We conducted a comprehensive literature search, which found 46 relevant articles on obesity in older adults and effects on nursing home facilities. This review indicated obesity is increasing globally for all age groups and older adults are facing increased challenges with chronic diseases associated with obesity more than ever before. With medical advances comes greater life expectancy, but obese adults often experience more disabilities, which require nursing home care. In the United States, the prevalence of obesity in adults aged 60 years and older increased from 9.9 million (23.6%) to 22.2 million (37.0%) in 2010. Obese older adults are twice as likely to be admitted to a nursing home. Many obese adults have comorbidities such as Type 2 diabetes; patients with diabetes incurred 1 in every 4 nursing home days. Besides the costs of early entrance into nursing facilities, caring for obese residents is different than caring for nonobese residents. Obese residents have more care needs for additional equipment, supplies, and staff costs. Unlike emergency rooms and hospitals, nursing homes do not have federal requirements that require them to serve all patients. Currently, some nursing homes are not prepared to deal with very obese patients. This is a public health concern because there are more obese people than ever in history before and the future appears to have even a heavier generation moving forward. Policymakers need to become aware of this serious gap in nursing home care.


2011 ◽  
Vol 199 (5) ◽  
pp. 367-372 ◽  
Author(s):  
Matthias C. Angermeyer ◽  
Anita Holzinger ◽  
Mauro G. Carta ◽  
Georg Schomerus

BackgroundBiological or genetic models of mental illness are commonly expected to increase tolerance towards people with mental illness, by reducing notions of responsibility and blame.AimsTo investigate whether biogenetic causal attributions of mental illness among the general public are associated with more tolerant attitudes, whether such attributions are related to lower perceptions of guilt and responsibility, to what extent notions of responsibility are associated with rejection of people who are mentally ill, and how prevalent notions of responsibility are among the general public with regard to different mental disorders.MethodA systematic review was conducted of representative population studies examining attitudes towards people with mental illness and beliefs about such disorders.ResultsWe identified 33 studies relevant to this review. Generally, biogenetic causal attributions were not associated with more tolerant attitudes; they were related to stronger rejection in most studies examining schizophrenia. No published study reported on associations of biogenetic causal attributions and perceived responsibility. The stereotype of self-responsibility was unrelated to rejection in most studies. Public images of mental disorder are generally dominated by the stereotypes of unpredictability and dangerousness, whereas responsibility is less relevant.ConclusionsBiogenetic causal models are an inappropriate means of reducing rejection of people with mental illness.


2017 ◽  
Vol 4 (1) ◽  
pp. 001-005
Author(s):  
Tutut Pujianto ◽  
Retno Ardanari Agustin

Mental health is an integral part of health, and a condition that affects the physical, mental, and  social  development  of  the  individual  optimally.  Mental  disorder  is  disturbances  in:  cognitive, volition, emotion (affective), and actions (psychomotor). Mental disorder is a collection of abnormal circumstances, whether physically related, or mentally. It is divided into two groups, namely: mental disorder  (neurosis)  and  mental  illness  (psychosis).  Mental  disorder  is  caused  by  some  of  the  above causes affected simultaneously or coincidence occurs. The purpose of this study was to increase the role of family and society in the treatment of mental disorder patients which was consequently could reduce the number of mental disorders patients This research used obsevational design with descriptive analy- sis. The subjects were family members who treat mental disorder patients as much as 16 respondents. The data collection was done in October 2012. The family role data grouped into appropriate and inappro- priate  category.  The  research  found  that  11  people  (68.75%)  in  the  category  of  inappropriate,  and appropriate by 5 people (31.25%), with average family role of 63.19%. The higher of inappropriate category was because 9 respondents (56.25%) in the age of elderly (> 50 years). This condition caused a decrease in the ability to perform daily activities, including health treatment. There were 4 patients who have been treated for 7-14 years, so the family feels accustomed to the condition of the patient. There were 8 people (50%) in productive age treated the patients, so it could not be done continuously. Based on these conditions, there should be efforts to increase knowledge and willingness of the patients and families, in caring for patients with mental disorders. The examples of such activities were to consult with the nearest health employees, and report to the health worker if there is a risky condition immedi- ately.


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