An examination of the needs of older patients with chronic mental illness in public mental health services.

OBJECTIVES

To describe the needs of patients aged 50 years and over with chronic mental illness being case managed within a public mental health service, and to determine factors that influence these needs.

METHOD

Patients were recruited from community-based Adult Mental Health (AMH) teams and Specialist Mental Health Services for Older People (SMHSOP) teams. Eligibility criteria included a diagnosis of schizophrenia or mood disorder. Patient, carer and key worker interviews were carried out using the Camberwell Assessment of Need for the Elderly (CANE).

RESULTS

Of 183 eligible patients, 97 (mean age of 66.4 years) participated, of whom 63 were managed by AMH teams and 34 by SMHSOP teams. The majority (52%) had a diagnosis of schizophrenia, particularly those managed by AMH (71%). Patients self-rated fewer needs overall on the CANE than their key workers or the researcher, and also rated a higher proportion of their needs being met (83%) than the key worker (77%) or researcher (76%). From each perspective, over 80% of psychiatric and around 95% of identified medical needs were being met. The majority of social needs were unmet, with patients reporting only 42%, and key workers only 33%, met needs. The key unmet social needs were company, daily activities and having a close confidant. Key workers, patients and researchers rated SMHSOP service delivery to have significantly less unmet needs.

CONCLUSIONS

The social needs of older patients with chronic mental illness require greater attention by public mental health services.