A tiered model of psychogeriatric service delivery: an evidence-based approach.

BACKGROUND

Previous models of mental health care for older persons have not considered the full spectrum of mental disorders.

AIM

To describe a tiered model for comprehensive evidence-based planning of service delivery for mental disorders in late life.

METHOD

The model depicts tiers of mental disorders in ascending order of severity and consequent interventions required.

RESULTS

Interventions aim both to avert individuals from moving up tiers (prevention) and to move individuals down tiers (treatment). Individuals in the lower tiers have no mental disorders and prevention strategies are targeted at known risk factors. In the middle tiers, individuals with mild-moderate mental disorders will mainly be treated in primary care, often in collaboration with specialist mental health services for older people. Individuals in the top tiers with severe mental disorders usually require institutional care.

CONCLUSION

The tiered model provides a basis for planning comprehensive service delivery.