School of Medicine, Keele University, Staffordshire, UK.
Research and Innovation Department, Midlands Partnership University NHS Foundation Trust, Stafford, UK.
Health Expect. 2024 Oct;27(5):e70028. doi: 10.1111/hex.70028.
Anxiety and depression in older adults (60+ years of age) are under-diagnosed and under-treated. Older adults are less likely to seek help for these problems due to a lack of awareness, difficulty accessing health care due to availability or disability and fear of loss of independence. Existing points of contact between older adults and non-traditional services, for example, the Fire and Rescue Service (FRS), could provide opportunities to support help-seeking for mental ill-health. The FRS conduct Home Fire Safety Visits (HFSVs) with older adults and are well positioned to provide health-related support. This study examines a range of perspectives on the potential role of the FRS in the identification of, and signposting for, anxiety and depression in older adults.
This was a qualitative study carried out using mixed methods in West Midlands, UK. Semi-structured interviews were conducted with older adults and health and social care providers (practitioners, managers, commissioners) to explore the acceptability of the FRS expanding its role to detect and signpost for anxiety and depression in older adults. Observations examined delivery of existing HFSVs to older adults. Data were combined and analysed using a reflexive thematic approach.
Eighteen health and social care providers and 8 older adults were interviewed; 10 HFSVs were observed. Two overarching themes were identified: (1) Potential role for the FRS and (2) Operationalising identification of mental health problems by FRS. Interviews and observations demonstrated how HFSVs offer a suitable opportunity to start conversations about mental health. All interview participants felt that although the FRS would be well placed to deliver an intervention, they would require training, support and a referral pathway co-produced with and supported by health and social care partners.
A whole-system approach is needed if the FRS are to expand HFSVs to identify mental health problems in older adults and provide signposting to appropriate services.
J.S. is a public co-investigator. A Patient Advisory Group contributed to the initial funding application, design and conduct of the study, including data analysis and advice on dissemination.
老年人（60 岁及以上）的焦虑和抑郁症状常常被漏诊和治疗不足。老年人因缺乏意识、因可用性或残疾而难以获得医疗保健以及担心丧失独立性，不太愿意寻求这些问题的帮助。老年人与非传统服务之间现有的接触点，例如消防和救援服务（FRS），可以为支持心理健康寻求帮助提供机会。这项研究探讨了 FRS 在识别和转介老年人焦虑和抑郁方面的潜在作用的各种观点。
这是一项在英国西米德兰兹郡进行的定性研究，采用混合方法。对老年人和卫生与社会保健提供者（从业者、经理、决策者）进行半结构化访谈，以探讨 FRS 扩大其角色以识别和转介老年人焦虑和抑郁的可接受性。观察检查了为老年人提供的现有家庭消防安全访问（HFSV）的交付情况。使用反思性主题分析方法结合和分析数据。
共访谈了 18 名卫生和社会保健提供者和 8 名老年人，观察了 10 次 HFSV。确定了两个总体主题：（1）FRS 的潜在作用和（2）FRS 识别心理健康问题的操作化。访谈和观察表明，HFSV 提供了一个合适的机会，开始就心理健康问题进行对话。所有访谈参与者都认为，尽管 FRS 将非常适合提供干预措施，但他们需要与卫生和社会保健合作伙伴共同制定、支持和提供培训、支持和转介途径。
如果 FRS 要扩大 HFSV 以识别老年人的心理健康问题并提供适当服务的转介，需要采取全系统方法。
J.S. 是公共共同研究者。患者咨询小组为最初的资助申请、研究的设计和实施做出了贡献，包括数据分析和传播建议。
