Mental Health Services for Older Adults in Rural Areas: An Ecological Systems Approach

2008 ◽  
Vol 27 (3) ◽  
pp. 252-266 ◽  
Author(s):  
Gregory F. Sanders ◽  
Margaret A. Fitzgerald ◽  
Marlys Bratteli
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Rural Areas ◽  
Service Providers ◽  
Ecological Systems ◽  
Care Providers ◽  
Focus Group Study

Groups of North Dakota professionals from health and aging services participated in a focus group study of mental health needs and barriers to service among older adults. Data were collected from 13 focus groups that included human service providers, public health nurses, out-reach workers, and advisory groups who discuss mental health and aging issues in a number of ecological systems contexts. Lack of knowledgeable care providers, funding cutbacks, accessibility of services, and ageism were frequently cited barriers to mental health services for older adults in rural areas. Focus groups also discussed the needs of older adults including information on services, how to access services, the need for service providers in rural areas, and routine assessments by physicians. Participants suggested that the main needs of providers were education, more services, and changes or flexibility in the types of services.

scholarly journals Self-identified barriers to rural mental health services in Iowa by older adults with multiple comorbidities: qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029976 ◽  
Author(s):  
Lauren Elizabeth Pass ◽  
Korey Kennelty ◽  
Barry L Carter
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Rural Areas ◽  
Service Providers ◽  
Mental Healthcare ◽  
Chronically Ill ◽  
Healthcare Services ◽  
Qualitative Interview Study

ObjectivesIndividuals in rural areas face critical health disparities, including limited access to mental healthcare services and elevated burden of chronic illnesses. While disease outcomes are often worse in individuals who have both physical and mental comorbidities, few studies have examined rural, chronically-ill older adults’ experiences accessing mental health services. The aim of the study was to determine barriers to finding, receiving and adhering to mental health treatments in this population to inform future interventions delivering services.DesignWe conducted a qualitative study of barriers and facilitators to mental healthcare access. 19 interviews were analysed deductively for barriers using a modified version of Penchansky and Thomas’s theory of access as an analytical framework.SettingThis study was conducted remotely using telephonic interviews. Patients were located in various rural Iowa towns and cities.Participants15 rural Iowan older adults with multiple physical comorbidities as well as anxiety and/or depression.ResultsWe found that while patients in this study often felt that their mental health was important to address, they experienced multiple, but overlapping, barriers to services that delayed care or broke their continuity of receiving care, including limited knowledge of extant services and how to find them, difficulties obtaining referrals and unsatisfactory relationships with mental health service providers.ConclusionsOur findings indicate that intervention across multiple domains of access is necessary for successful long-term management of mental health disorders for patients with multiple chronic comorbidities in Iowa.

scholarly journals Teaching Family Nurse Practitioner Students to Provide Mental Health Care to Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 10-11
Author(s):  
Victoria Grando ◽  
Roy Grando
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Plan ◽  
Primary Care Providers ◽  
Neurocognitive Disorders ◽  
Mental Condition ◽  
Care Providers

Abstract In recent years, FNPs have been challenged to deliver mental health services in the primary care setting. Over half of mental health services are provided in primary care, and one-quarter of all primary care patients have a mental disorder. Moreover, 20% of older adults have a mental or neurological disorder often not diagnosed. Nationally, it is estimated that 17% of older adults commit suicide, 15% have a mental condition, 11% have dementia, and 5% have a serious mental condition. There is a paucity of adequately prepared primary care providers trained in geropsychiatric treatment. A didactic course was developed to instruct FNP students in the skills needed to provide mental health treatment in primary care. We discuss mental illness in the context of culture to ensure that treatment is congruent with a patient’s unique cultural background and experiences. This shapes the patients’ beliefs and behaviors that influence the way they view their condition and what they perceive as acceptable solutions. We then go into detail about the common mental conditions that older adults exhibit. Through the case study method, students learn to identify the presenting problem, protocols for analyzing the case, which includes making differential diagnoses and a treatment plan including initial medications, non-medical treatments, and referral. Students are introduced to the DMS-5 to learn the criteria for mental health diagnosis with an emphasis on suicide, depressive disorders, anxiety disorders, bipolar disorders, substance use disorders, and neurocognitive disorders. We have found that students most often misdiagnose neurocognitive disorders.

Enhancing Successful Employment Outcomes for People with a Psychiatric Disability

1997 ◽  
Vol 3 (2) ◽  
pp. 57-64
Author(s):  
Maxie Ashton ◽  
Josephine Dowsett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Service Providers ◽  
Psychiatric Disability ◽  
Rehabilitation Services ◽  
Important Goal ◽  
Rehabilitation Process ◽  
Successful Employment

Work, for most people with psychiatric disability, is their most important goal and yet they often have more difficulty getting work and maintaining work than other disability groups. Six focus groups were held with consumers of mental health services to explore the reason for this and identify what rehabilitation services should do about this problem. The groups recommended many strategies which have been divided by the authors into three rehabilitation phases. Three check lists have been developed to assist service providers address the range of needs with consumers during the rehabilitation process and to identify service gaps.

scholarly journals Unmet Needs for Mental Health Services for Latino Older Adults: Perspectives from Consumers, Family Members, Advocates, and Service Providers

2007 ◽  
Vol 44 (1) ◽  
pp. 57-74 ◽  
Author(s):  
Concepción Barrio ◽  
Lawrence A. Palinkas ◽  
Ann-Marie Yamada ◽  
Dahlia Fuentes ◽  
Viviana Criado ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Unmet Needs ◽  
Service Providers ◽  
Family Members ◽  
Latino Older Adults

Rural Ethics and Mental Health: An Overview for Rehabilitation Counselors

2015 ◽  
Vol 46 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Wendy A. Coduti ◽  
Melissa Manninen Luse
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Ethical Issues ◽  
Service Providers ◽  
Rehabilitation Counselors ◽  
Ethical Challenges ◽  
Health Service Providers

Individuals living in rural areas have similar prevalence rates of mental health conditions as individuals living in urban areas, yet face a number of challenges in accessing and receiving proper mental health services. For mental health service providers there are unique ethical challenges when working in rural areas. This paper will examine aspects of rural living, and ethical issues surrounding provision of mental health services. Implications for practice and research are assessed for rehabilitation counselors working in these settings.

scholarly journals Mental Health Care Delivery for Older Adults in Rural Greece: Unmet Needs

2019 ◽  
Vol 10 (04) ◽  
pp. 721-724
Author(s):  
Vaios Peritogiannis ◽  
Charalampos Lixouriotis
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
The Elderly

AbstractMental disorders may go unrecognized and undertreated in older adults. This is the rationale for the launch of specialized mental health services for the elderly in high resourced settings. Rural areas, however, do not receive adequate mental health care owing to socioeconomic and geographical reasons, and this is the case of rural Greece, where research on mental health of the elderly is scarce. This article discusses the challenges of providing mental health care for older adults in rural Greece and the available options. Care can be delivered through the existing rural mental health services that are the mobile mental health units and through the primary care physicians. Training in psychogeriatrics for the personnel of the former and in mental health for the latter is warranted.

Personality and Barriers to Mental Health Services Among Older Adults

2009 ◽  
Author(s):  
Renee L. Pepin ◽  
Daniel L. Segal ◽  
Frederick L. Coolidge
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services

The Bridge Program: A Model for Delivering Mental Health Services to Asian Americans through Primary Care

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Asian Americans ◽  
Mental Health Professionals ◽  
Primary Care Providers ◽  
Care Providers ◽  
Bridge Program ◽  
Community Awareness

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.

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