scholarly journals Assessing DNA rates for new referrals in older adults

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S179-S179
Author(s):  
Aamina Cheema ◽  
Nasir Pasha ◽  
Giorgi Gurieli
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older Adult ◽  
Waiting Time ◽  
Initial Assessment ◽  
National Guidelines ◽  
Asthma Attack ◽  
Retrospective Audit ◽  
Initial Appointment ◽  
The Uk

AimsTo assess DNA rates for initial assessment medical appointments offered for new referrals within an Older Adults CMHT.To establish any correlation between waiting time and DNA rates.To establish if the initial appointments offered were in keeping with the National guidelines (18 weeks) and our local Trust policy (1-4 weeks).BackgroundIn the Uk 15% of adults 60 and above suffer from a mental disorder. Despite the increasing mental health burden, analysis indicate that a quarter of mental health trust received less investment from 2017 to 2018. Financial pressures have also increased appointment waiting time. The NHS has stated that by 2023 there will be a 4-week waiting time for older adult mental health services. Current national guidelines state that initial referrals should be seen within 18 weeks.MethodThis is a retrospective audit looking at all first time referrals to an Older Adult CMHT in East Birmingham. 110 patients were included in this audit. Factors recorded included age, gender, reason for referral, waiting time for appointment, and whether this complies with guidelines.Electronic patients' notes (RIO) were used for data collection.ResultOut of 110 new referrals 11 were not offered any appointments. Out of the remaining 99, 13 cancelled and 8 did not attend.In total, 78 attended the initial appointment offered, out of which 77 were seen within 18 weeks as per national guidelines. 43 patients were seen within the 4-week period (trust policy). 1 patient was offered an appointment at 19 weeks and 3 days from the referral date. The patients who did not attend their appointments were followed up except for one, to find out the reasons of the DNA. This included 2 (physically unwell), 1 (unaware of appointment), 1 (refused), 1 (forgot), 1 (couldn't get to clinic), 1 (asthma attack). Another appointment was offered to those who could attend.ConclusionThere was no significant correlation between a longer waiting time and an increased DNA rate for first appointments. Even though the time for an initial appointment was within the NHS guidelines, only 56% of the appointments met our Trust's policy of a 4 week wait.When discussing the results with the relevant team it was clear that a number of factors affected the waiting time including: number of available clinicians and a large catchment area.

scholarly journals Physical Inactivity in Older Adult Couples: A Dyadic Analysis Using Continuous In-Home Monitoring

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 412-412
Author(s):  
Chao-Yi Wu ◽  
Lyndsey Miller ◽  
Rachel Wall ◽  
Zachary Beattie ◽  
Jeffrey Kaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older Adult ◽  
Physical Inactivity ◽  
Home Monitoring ◽  
Health Determinants ◽  
Dyadic Analysis ◽  
Physical And Mental Health ◽  
Positive Health ◽  
Aging Research

Abstract Many older adults remain inactive despite the known positive health implications of physical activity (e.g. improved mood, reduced mortality risk). Physical inactivity is a known interdependent phenomenon in couples, but the majority of research identifies determinants of physical inactivity at the individual level. We estimated the average amount of physical inactivity for older adult couples and, using dyadic analysis, identified physical and mental health determinants thereof. Forty-eight heterosexual older adult couples (mean age=70.6, SD=6.63) from the Veterans Integrated Service Network 20 cohort of the Collaborative Aging Research using Technology (CART) initiative were included in this study. Both dyad members wore actigraph devices for a month. The average number per day of inactive periods (defined as no movement or sleep activity for ≥ 30 minutes) was estimated. Multilevel modeling revealed that, within couples, there was no difference between partners in the average number of inactive periods, but on average across couples, males had more inactive periods per day (13.4, SD=4.43) than females (12.3, SD=4.87). For males, older age was the only variable associated with more inactive periods (β=0.13, p=.013). For females, more depressive symptoms in men were associated with fewer inactive periods (β=-0.37, p=.002), and more dependence in completing their own IADLs predicted more inactive periods (β=2.80, p<.001). All models were adjusted for covariates. Viewing couples’ activity as a unit, rather than as separate individuals, provides a novel approach to identifying pathways to reduce inactivity in older adults, especially when focusing on mental health issues and decreased independence within the couple.

scholarly journals An Innovative Mental Health Model for Treating Culturally Diverse Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 93-93
Author(s):  
Tobi Abramson ◽  
Jacquelin Berman ◽  
Madison Gates
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Social Isolation ◽  
Older Adult ◽  
Culturally Diverse ◽  
Spanish Speakers ◽  
English Speakers ◽  
Chinese Speakers

Abstract The mental health needs of older adults are largely unmet, a finding even more prevalent within culturally diverse older adult populations. Added to this is the high rate of social isolation. Research has indicated increased connection to mental health services when services are embedded within physical health care settings. For those attending community centers, 85% indicate that they are socially isolated, 68% indicate they are lonely, and 53% have a mental health need (compared to 20% nationally). The need for innovative programming is evident. When examining the needs of diverse older adults, it is increasingly important that new and innovative approaches address social isolation, loneliness, and mental health problems experienced by this cohort. Utilizing this knowledge an innovative model of embedding and integrating mental health services, provided by bilingual and bicultural clinicians, into congregate sites (older adult centers) was implemented. Those that participated were mainly female (72.1%), 68.5% English-speaking, 14.5% Spanish-speaking, 13.6% Chinese-speaking and 3.4% other. Spanish-speakers had more depression than English-speakers and both had more depression than Chinese-speakers. English and Spanish-speakers reported more social isolation and Chinese-speakers compared were more likely to participate in engagement. Chinese-speakers were less likely to be in clinical services with a positive screen compared to English-speakers. Overall, 75% engaged in treatment; 37.3% and 41% showed a 3-month improvement of depression and anxiety, respectively. This presentation focuses on the innovative components of this model, how to engage diverse older adults to utilize treatment, steps needed for replication, and policy implications around integrated mental health treatment.

London Fire Brigade's screen and treat approach to the Grenfell Tower incident

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Craig Steel ◽  
Zoe Travers ◽  
Lynette Meredith ◽  
Deborah Lee ◽  
Michael Conti ◽  
...  
Keyword(s):  
Mental Health ◽  
Design Methodology ◽  
Stress Disorder ◽  
National Guidelines ◽  
Line Managers ◽  
Content Type ◽  
Health Response ◽  
The Uk ◽  
Post Disaster ◽  
Practical Implications

PurposeThe purpose is to report on the mental health response to the Grenfell incident within the London Fire Brigade (LFB).Design/methodology/approachThe LFB implemented screening for the symptoms of posttraumatic stress disorder (PTSD) at 28 days, 3 months and 6 months for all personnel directly involved in the incident.FindingsThe prevalence of PTSD within frontline personnel was 13.4% at 28 days, falling to 7.6% at 6 months. The LFB's internal Counselling and Wellbeing Service offered treatment to those scoring above the cut-off for PTSD along with accepting self-referral and referrals from line managers and occupational health. There were 139 referrals within the 12-month period following the incident.Research limitations/implicationsThe outcomes for those who engaged in treatment are broadly in line with other studies evaluating post-disaster interventions. Issues for consideration within national guidelines are discussed.Practical implicationsThe screen and treat approach adopted by LFB was shown to be a feasible approach to use within such a scenario.Originality/valueThe current study reports on a screen and treat approach to one of the largest single incidents in the UK in recent years.

scholarly journals An Innovative Mental Health Model for Treating Culturally Diverse Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 504-505
Author(s):  
Tobi Abramson ◽  
Jacquelin Berman ◽  
Madison Gates
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Social Isolation ◽  
Older Adult ◽  
Culturally Diverse ◽  
Spanish Speakers ◽  
English Speakers ◽  
Chinese Speakers

Abstract The mental health needs of older adults are largely unmet, a finding even more prevalent within culturally diverse older adult populations. Added to this is the high rate of social isolation. Research has indicated increased connection to mental health services when services are embedded within physical health care settings. For those attending community centers, 85% indicate that they are socially isolated, 68% indicate they are lonely, and 53% have a mental health need (compared to 20% nationally). The need for innovative programming is evident. When examining the needs of diverse older adults, it is increasingly important that new and innovative approaches address social isolation, loneliness, and mental health problems experienced by this cohort. Utilizing this knowledge an innovative model of embedding and integrating mental health services, provided by bilingual and bicultural clinicians, into congregate sites (older adult centers) was implemented. Those that participated were mainly female (72.1%), 68.5% English-speaking, 14.5% Spanish-speaking, 13.6% Chinese-speaking and 3.4% other. Spanish-speakers had more depression than English-speakers and both had more depression than Chinese-speakers. English and Spanish-speakers reported more social isolation and Chinese-speakers compared were more likely to participate in engagement. Chinese-speakers were less likely to be in clinical services with a positive screen compared to English-speakers. Overall, 75% engaged in treatment; 37.3% and 41% showed a 3-month improvement of depression and anxiety, respectively. This presentation focuses on the innovative components of this model, how to engage diverse older adults to utilize treatment, steps needed for replication, and policy implications around integrated mental health treatment.

Mental Health and Older Adults

2020 ◽  
Author(s):  
Hee Yun Lee ◽  
William Hasenbein ◽  
Priscilla Gibson
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Old Age ◽  
Social Isolation ◽  
Older Adult ◽  
Adult Population ◽  
Depression And Anxiety ◽  
Health Issues ◽  
Mental Health Issues ◽  
Older Adult Population

As the older adult population continues to grow at a rapid rate, with an estimated 2.1 billion older adults in 2050, social welfare researchers are determined to fill the shortage of gerontological social workers and structural lag to best serve the baby boomers who are expected to need different services than previous generations. Mental illness impacts over 20% of older adults in the world and the United States. The major mental health issues in older adults include depression, anxiety, loneliness, and social isolation. Depression is considered one of the most common mental health issues among this population; however, the prevalence could be underestimated due to older adults linking relevant symptoms to other causes, such as old age, instead of as possible depression. Like depression, anxiety symptoms are often mistaken as results of aging. It is also difficult for providers to diagnose anxiety in this population due to anxiety frequently being coupled with other illnesses and the psychological stress that comes with old age. Because the presence of loneliness or social isolation can manifest depression and anxiety symptoms in older adults, it is also difficult to separate these two issues. With the anticipated increase of the older adult population within the next few years, measurement tools have been created to assess depression and anxiety specifically for older adults. In addition to adapting assessment tools, interventions tailored to older adults are essential to ensure treatment coherence, even though medications are the go-to treatment option.

Older adult recovery: “What are we working towards?”

2016 ◽  
Vol 21 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Samantha Rankin ◽  
Stephanie Petty
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Clinical Practice ◽  
Older Adult ◽  
Later Life ◽  
Mental Health Setting ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Content Type ◽  
Inpatient Mental Health

Purpose – The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach – Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings – Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value – Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood.

scholarly journals Deciphering the role of physical activity in stress management during a global pandemic in older adult populations: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ryan Churchill ◽  
Indira Riadi ◽  
Lucy Kervin ◽  
Kelly Teo ◽  
Theodore Cosco
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Stress Management ◽  
Psychological Stress ◽  
Older Adult ◽  
Activity Level ◽  
Sufficient Evidence ◽  
Physical Activity Interventions

Abstract Background The world has changed dramatically since the beginning of 2020 due to COVID-19. As a result of the pandemic, many older adults are now experiencing an increased and unprecedented amount of psychological stress. Physical activity has been found to be an evidence-based means of combating stress among older adults to promote their quality of life. Studies have demonstrated that those who are physically active experience fewer issues in regard to their mental health, specifically depression and anxiety disorders. Engagement in physical activity may exert a protective influence over stress inducing events and future mental health outcomes. Due to exercise being inexpensive, non-invasive, and effective even via incremental increases in activity level, physical activity interventions should be investigated as a therapy for reducing stress for older adults during the current pandemic. Methods Four electronic databases (PubMed, PsycInfo, Web of Science, and SportDiscus) will be searched to identify randomized controlled trials that evaluate the effectiveness of physical activity or exercise programs as a psychological stress management tool in adults 50 years of age or older. Only peer-reviewed and published journal articles will be reviewed. Post-intervention psychological stress measures in comparison to baseline stress will be the primary outcome of interest. All studies will be assessed for bias using Cochrane’s risk of bias tool. A random effects meta-analysis will be investigated if sufficient evidence of homogenous research exists and the heterogeneity of effect sizes will be tabulated. Discussion This review will determine the effectiveness of various physical activity interventions for the treatment of psychological stress among the older adult population. This knowledge will help inform care aides, clinicians, family members, and older adults themselves of the most effective physical activity interventions in dealing with stress which is relevant to the ongoing pandemic. Systematic review registration PROSPERO CRD42020192546

Problem Gambling in a Sample of Older Adult Casino Gamblers

2016 ◽  
Vol 30 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Mark van der Maas ◽  
Robert E. Mann ◽  
John McCready ◽  
Flora I. Matheson ◽  
Nigel E. Turner ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Problem Gambling ◽  
Older Adult ◽  
Lower Risk ◽  
Leisure Activities ◽  
Well Being ◽  
Physical And Mental Health ◽  
Gambling Participation ◽  
Canadian Population

As older adults continue to make up a greater proportion of the Canadian population, it becomes more important to understand the implications that their leisure activities have for their physical and mental health. Gambling, in particular, is a form of leisure that is becoming more widely available and has important implications for the mental health and financial well-being of older adults. This study examines a large sample (2103) of casino-going Ontarian adults over the age of 55 and identifies those features of their gambling participation that are associated with problem gambling. Logistic regression analysis is used to analyze the data. Focusing on types of gambling participated in and motivations for visiting the casino, this study finds that several forms of gambling and motivations to gamble are associated with greater risk of problem gambling. It also finds that some motivations are associated with lower risk of problem gambling. The findings of this study have implications related to gambling availability within an aging population.

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