Draper Brian, Jochelson Tanya, Kitching David, Snowdon John, Brodaty Henry, Russell Bob
School of Psychiatry, Universityof New South Wales, Sydney, Australia.
Aust N Z J Psychiatry. 2003 Dec;37(6):735-40. doi: 10.1080/j.1440-1614.2003.01259.x.
To compare the perceptions of aged care services, adult mental health services and mental health services for older people regarding aspects of mental health service delivery for older people in New South Wales, Australia.
The NSW Branch of the Faculty of Psychiatry of Old Age in association with the NSW Centre for Mental Health, sent a postal survey to all aged care services, adult mental health services and mental health services for older people in NSW. The survey canvassed issues ranging across service profiles, regional variations, availability of resources, processes of care, views on working relationships between services, difficulties and gaps experienced, and ways to improve co-ordination and service delivery. Clinical issues such as the management and practice of psychiatric disorders of old age, educational/training requirements and skill and experience in working with older people were explored.
An overall response rate of 86% was achieved, including 95% from aged care services (n = 58), 74% from adult mental health services (n = 62) and 90% from mental health services for older people (n = 20). Only 59% of aged care services and adult mental health services considered that their local mental health services for older people provided an adequate service; resource and budget limitations were portrayed as the main constraint. Mental health services for older people varied widely in structure, settings and activities undertaken. Access to mental health beds for older people was also variable, and alongside staffing levels was considered problematic. Lack of staff training and/or inexperience in psychogeriatrics posed a challenge for aged care services and adult mental health services.
Relationships between aged care services, adult mental health services and mental health services for older people are affected by lack of access to psychogeriatric staff, resource limitations of mental health services for older people, and inadequate liaison and support between the service types. Joint case conferences, education, increased funding of mental health services for older people, and cross referrals were considered ways to address these issues.
比较澳大利亚新南威尔士州老年护理服务、成人心理健康服务和老年人心理健康服务在老年人心理健康服务提供方面的认知情况。
老年精神病学系新南威尔士州分会与新南威尔士州心理健康中心联合向新南威尔士州所有老年护理服务、成人心理健康服务和老年人心理健康服务机构发送了一份邮政调查问卷。该调查涵盖了服务概况、地区差异、资源可用性、护理流程、对服务间工作关系的看法、遇到的困难和差距以及改善协调和服务提供的方法等问题。探讨了老年精神疾病的管理和实践、教育/培训要求以及与老年人合作的技能和经验等临床问题。
总体回复率达到86%，其中老年护理服务机构的回复率为95%（n = 58），成人心理健康服务机构的回复率为74%（n = 62），老年人心理健康服务机构的回复率为90%（n = 20）。只有59%的老年护理服务机构和成人心理健康服务机构认为其当地的老年人心理健康服务提供了充分的服务；资源和预算限制被描述为主要制约因素。老年人心理健康服务在结构、环境和开展的活动方面差异很大。老年人使用心理健康病床的情况也各不相同，与人员配备水平一样被认为存在问题。老年护理服务机构和成人心理健康服务机构面临着缺乏老年精神病学工作人员培训和/或经验不足的挑战。
老年护理服务、成人心理健康服务和老年人心理健康服务之间的关系受到老年精神病学工作人员获取困难、老年人心理健康服务资源限制以及服务类型之间联络和支持不足的影响。联合病例讨论会、教育、增加老年人心理健康服务的资金投入以及交叉转诊被认为是解决这些问题的方法。
