Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T12:28:28.324Z Has data issue: false hasContentIssue false
  • English
  • Français

Developing a National Consensus on the Accessibility Needs of Older Adults with Concurrent and Chronic, Mental and Physical Health Issues: A Preliminary Framework Informing Collaborative Mental Health Care Planning*

Published online by Cambridge University Press:  01 June 2009

Salinda Horgan ,
Ken LeClair ,
Martha Donnelly ,
Geri Hinton ,
Penny MacCourt  and
Sarah Krieger-Frost
Salinda Horgan*
Affiliation:
Division of Geriatric Psychiatry, Dept. of Psychiatry, Queen’s University
Ken LeClair
Affiliation:
Division of Geriatric Psychiatry, Dept. of Psychiatry, Queen’s University
Martha Donnelly
Affiliation:
Division of Geriatric Psychiatry, Dept. of Psychiatry, UBC
Geri Hinton
Affiliation:
Family Caregiver; Executive Director, Office for Seniors (retired)
Penny MacCourt
Affiliation:
Research Affiliate, Centre on Aging, University of Victoria
Sarah Krieger-Frost
Affiliation:
Seniors Mental Health Team, Capital Health District
*
†Correspondence to: / Correspondance à : Salinda Horgan, PhD Manager, Program Evaluation & Health Services Development Geriatric Psychiatry Service, Providence Care (MHS) & Assistant Professor, Geriatric Division Department of Psychiatry, Queen’s University 752 King Street West, Postal Bag 603, Kingston, Ontario, K7L 4X3 Phone: (613) 548-5567 x.5896 Fax: (613) 540-6128 Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Canada faces a significant challenge in meeting the health care needs of older adults with complex mental and physical health issues. Studies have shown collaborative mental health services to effectively address the diverse health needs of this group. However, an often overlooked yet important aspect of service delivery planning for this population is to ensure that older adults are sufficiently able to access available best-practice services. The article reports on a national consensus-building exercise conducted by the Collaborative Mental Health Initiative—Seniors Working Group to develop a nationally informed framework on the accessibility needs of older adults as they relate to collaborative mental health care. The framework is intended to provide planners, administrators, and providers with an understanding of the unique accessibility needs of older adults across three priority pillars (personal, caregiver, systemic) and to enable them to embed strategies to address these issues within field-based collaborative mental health initiatives.

Résumé

Le Canada fait face à un défi important, soit de répondre aux besoins en soins de santé des personnes âgées manifestant des problèmes physiques et mentaux complexes. Les études montrent que les services de santé mentale en collaboration sont efficaces en ce qui concerne les divers besoins de santé de ce groupe. Cependant, un aspect négligé, néanmoins important, de la planification de la prestation de services pour cette population est de s’assurer que les personnes âgées ont suffisamment accès aux services de pratiques d’excellence offerts. Cet article présente un exercice national de réalisation de consensus mené par l’Initiative canadienne de collaboration en santé mentale – Seniors Working Group. L’objectif de la réalisation de consensus est de développer, à l’aide de renseignements provenant de tout le paysQ1: Ok, oui c bon je comprends. si ton cadre conceptuel est nationally informed, c’est que forcément il reçoit de l'info de partout dans le pays. C’est pourquoi je l’ai traduit comme ça. Pour rester plus proche de l'anglais, on pourrait mettre kekchose comme obtenant des renseignements sur le plan national..?, un cadre conceptuel sur les besoins d’accessibilité des personnes âgées relatifs aux soins de santé mentale en collaboration. Le cadre conceptuel a pour but de fournir aux planificateurs, administrateurs et fournisseurs les éléments nécessaires pour comprendre les besoins uniques des personnes âgées en matière d’accessibilité, en fonction de trois priorités (l’élément personnel, systémique, et les prestataires de soins), et de leur permettre d’implanter des stratégies pour résoudre ces problèmes, à l’intérieur d’initiatives collaboratives de santé mentale mises en place sur le terrain.

Keywords

soins de santé mentale pour les personnes âgéessoins de santé mentale en collaborationplanification des soins en santé mentaleseniors mental healthcollaborative mental health carehealth care planning
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 28 , Issue 2 , June 2009 , pp. 97 - 105
Copyright
Copyright © Canadian Association on Gerontology 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors are grateful to the participants who shared their knowledge and gave of their time to develop a robust and practical framework to inform collaborative mental health care planning for older adults with complex needs. The authors also gratefully acknowledge the two consultants, Ms. Linda Kessler and Dr. Brian Draper, who provided valuable feedback on the final iteration of the framework and associated toolkit. Acknowledgment is made to the Canadian Collaborative Mental Health Initiative for supporting the data collection and consensus planning process. The authors are indebted to the two anonymous reviewers for their helpful comments and suggestions.

References

Barr, J.J.F., & Dixon, P.J. (2000). Methods for consensus building for management of common property resources. Final technical report R7562. Newcastle, England: University of Newcastle, Centre for Land Use and Water Resources Research.Google Scholar
Bartels, S. (2004) Caring for the whole person: Integrated health care for older adults with severe mental illness and medical comorbidity. Journal of the American Geriatric Society, 52, 5249–5257.Google Scholar
Bruce, M.L., Ten Have, T.R., Reynolds, C.F., Katz, I.I., Schilberg, H.C., Mulsant, B.H., et al. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized clinical trial. Journal of the American Medical Association, 291(9), 1081–1091.Google Scholar
Callahan, C. (2001). Quality improvement research on late life depression in primary care. Medical Care, 39(8), 772–784.Google Scholar
Clyburn, L.D., Stones, M.J., Hadjistavrapoulos, T., & Tuokko, H. (2000). Predicting caregiver burden and depression in Alzheimer’s disease. Journal of Gerontology. Series B: Psychological Sciences and Social Sciences 55B(1), S2–S13.Google Scholar
Cradock-O’Leary, J., Young, A., Yano, E., Wong, M., & Lee, M. (2002). Use of general medical services by VA patients with psychiatric disorders. Psychiatric Services 53, 874–878.Google Scholar
Denzin, N., & Lincoln, Y. (1998). Strategies of Qualitative Inquiry. Thousand Oaks, CA: Sage.Google Scholar
Division of Aging & Seniors. (2002). Canada’s Aging Population. Ontario, Canada: Minister of Public Works & Government Services.Google Scholar
Donnie, J. (2004). The relationship between diabetes and depression: Improving the effectiveness of case management. Lippincott’s Case Management, 9(4), 177–183.Google Scholar
Donnelly, M., Le Clair, K., Hinton, G., Horgan, S., Kreiger-Frost, S., & MacCourt, P. (2006). Canadian Collaborative Mental Health Initiative. Establishing collaborative initiatives between mental health and primary care service for seniors: A companion to the CCMHI planning and implementation toolkit for health care providers and planners. Retrieved from http://www.ccmhi.caGoogle Scholar
Druss, B.G., Rosenheck, R.A., Desai, M.M., & Perlin, J.B. (2002). Quality of preventive medical care for patients with mental disorders. Medical Care, 40, 129–136.Google Scholar
Dugue, M. (2003). Growing body of health services research paints picture of mental health care system for older adults. Geriatric Psychiatry News, Sept-Oct, 9.Google Scholar
Gallo, J.J., Zubritsky, C., Maxwell, J., Nazar, M., Bogner, H.R., Quijano, L.M., et al. (2004). Primary care clinicians evaluate integrated and referral models of behavioural health care for older adults: Results from a multisite effectiveness trial (PRISM-E). Annals of Family Medicine, 2(4), 305–309.Google Scholar
Gilmour, H., & Park, J. (2006). Dependency, chronic conditions, and pain in seniors. Health Reports, 16, 21–31.Google Scholar
Graham, W. (1998). Primary care reform: A strategy for stability. Retrieved September, 2007 from http://www.oma.org/phealth/pcare/pcare.htmGoogle Scholar
Holmes, T., & Scoones, I. (2000). Participatory policy processes: Experiences from North and South. IDS Working Paper 113. Brighton: Institute of Development Studies.Google Scholar
Jeste, D.V., Gladsjo, J.A., Lindamer, L.A., & Lacro, J.P. (1996). Medical comorbidity in schizophrenia. Psychiatric Services, 22, 413–430.Google ScholarPubMed
Kaperski, J. (2002). The bells are ringing. Ontario Psychiatric Association Newsletter Dialogue, Mar,(14).Google Scholar
Kates, N. (2002). Shared mental health care: The way ahead (editorial). Canadian Family Physician, 48, 853–855.Google Scholar
Kates, N., Craven, M., Bishop, J., Clinton, T., Kraftcheck, D., LeClair, K., et al. (1997). Shared mental health care in Canada. Canadian Journal of Psychiatry [Supplement; 12pp.], 42(8).Google Scholar
Klinkman, M., & Okkes, I. (1998). Mental health problems in primary care: A research agenda. Journal of Family Practice, 47, 379–384.Google Scholar
Le Clair, K., Donnelly, M., Kates, N., Horgan, S., MacCourt, P., Hinton, G., et al. (2005). Collaborative care for seniors mental health: Creating a toolkit for service planning, implementation and evaluation. Paper presented at the Canadian Coalition of Seniors’ Mental Health National Best Practices Conference, Ottawa, ON. Available at http://www.ccsmh.caGoogle Scholar
Lepine, J.P., & Bouchez, S. (1998). Epidemiology of depression in the elderly. International Clinical Psychopharmacology [Supplement], 13, S7–S12.Google Scholar
Ministry of Health and Long-Term Care. (2006). Tier 3 Divestment: Principles to guide the transfer of non-bedded services from former provincial psychiatric hospitals to community mental health agencies in Ontario. Mental Health and Addiction Branch. http://www.health.gov.on.ca/english/providers/program/mentalhealth/mohtier3/tier3_faq.html. Retrieved September 2007.Google Scholar
Mirolla, M. (2004). The Cost of Chronic Disease in Canada. The Chronic Disease Prevention Alliance of CanadaGoogle Scholar
Rockman, P., Salach, L., Gotlib, D., Cord, M., & Turner, T. (2004). Shared mental health care: Model for supporting and mentoring family physicians. Canadian Family Physician, 50, 397–402.Google ScholarPubMed
Statistics Canada. (2005). Life expectancy. Retrieved September, 2007 from http://www.statcan.ca/english/freepub/82-221-XIE/2005001/hlthstatus/deaths2.htm.Google Scholar
Unutzer, J. (2002). Diagnosis and treatment of older adults with depression in primary care. Biological Psychiatry, 52, 285–292.Google Scholar
Unutzer, J., Katon, W., Callahan, C., Williams, J., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.Google Scholar
Wolf, J.L., Starfield, B., & Anderson, G. (2002). Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Journal of the American Medical Association, 162(20), 2269–2276.Google Scholar