Palinkas Lawrence A, Criado Viviana, Fuentes Dahlia, Shepherd Sally, Milian Hans, Folsom David, Jeste Dilip V
Department of Family and Preventive Medicine, the School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA.
Am J Geriatr Psychiatry. 2007 Jun;15(6):530-40. doi: 10.1097/JGP.0b013e3180381505.
The authors assessed the need for mental health services among older adults in San Diego County, California, by determining what needs were not being addressed by existing services, what services were necessary to address these needs, and how much consensus there was among different stakeholders with respect to the problems and solutions related to service delivery.
Semistructured interviews were conducted with 23 health care and social service providers and administrators, 16 services consumers and other older adults (55 years of age and older), and 19 caregivers/family members and patient/client advocates. This was followed by four focus groups comprised of 18 providers and administrators, six focus groups comprised of 50 consumers and other older adults, and five focus groups comprised of 39 caregivers (family members and advocates).
The unmet needs fell into three categories: mental health services, physical health services, and social services. Two interrelated themes were identified by participants: 1) the need for age-appropriate and culturally appropriate services to overcome barriers to mental health services access, use, and quality; and 2) the interrelations between unmet needs that address prevention as well as treatment of mental illness, including socialization and social support, transportation, housing, and physical health care. Differences in stakeholder assessment of unmet needs were associated with respective roles in delivery and use of mental health services.
Age-appropriate and culturally appropriate solutions that address both prevention and treatment may represent the best strategies for addressing the challenges of mental illness and are most likely to be endorsed by all three groups of stakeholders.
通过确定现有服务未满足的需求、满足这些需求所需的服务以及不同利益相关者在与服务提供相关的问题和解决方案上的共识程度，作者评估了加利福尼亚州圣地亚哥县老年人对心理健康服务的需求。
对23名医疗保健和社会服务提供者及管理人员、16名服务消费者和其他老年人（55岁及以上）以及19名护理人员/家庭成员和患者/客户倡导者进行了半结构化访谈。随后进行了四个由18名提供者和管理人员组成的焦点小组、六个由50名消费者和其他老年人组成的焦点小组以及五个由39名护理人员（家庭成员和倡导者）组成的焦点小组。
未满足的需求分为三类：心理健康服务、身体健康服务和社会服务。参与者确定了两个相互关联的主题：1）需要提供适合年龄和文化的服务，以克服获得、使用心理健康服务以及提高服务质量方面的障碍；2）未满足的需求之间的相互关系，这些需求涉及精神疾病的预防和治疗，包括社交和社会支持、交通、住房以及身体健康护理。利益相关者对未满足需求的评估差异与在心理健康服务提供和使用中的各自角色相关。
针对预防和治疗的适合年龄和文化的解决方案可能是应对精神疾病挑战的最佳策略，并且最有可能得到所有三组利益相关者的认可。
