Using epidemiologic survey data to plan geriatric mental health services.

A university medical center and a community mental health center undertook an epidemiologic survey of elderly residents of a county in North Carolina and used the data to plan a geriatric mental health program. The survey team assessed the rate and distribution of county residents 65 years and older with mental health impairment; defined the services necessary to treat the target population; identified the perceived need for services of these mentally impaired elderly; identified their current utilization of existing services; identified factors that affect utilization; and determined the type of personnel required to staff the new program. Among the elderly, mental health impairment was usually accompanied by functional impairment in other areas (social and economic resources, physical health, and activities of daily living); this finding suggests that a geriatric mental health program should not be limited to the treatment of mental illness but should be prepared to help elderly patients with other types of problems as well. A preliminary evaluation of the clinic's first year of operation indicates that the survey data were most useful in the planning process.