SS-07-01

The European network on old age psychiatry - resulting challenges for the EAGP

R. Ihl. Düsseldorf, Germany

Objective: Following the definition of the WHO, 52 nations belong to Europe. Concerning structures in Geriatric Psychiatry, the variety of cultures leads to a wide spectrum of quantitiy and quality of care. Most of the structures are unknown between nations and in most nations even within the nation. When a future structure of Geriatric Psychiatry shall be developed, this will be the first puzzle to be solved. Making services visible via the internet, might be a solution of this problem. Secondly, concerning healthy aging and treatment and care in Geriatric Psychiatry, the knowledge is poor leading to insufficient results and, moreover, to stigma. However, the knowledge for a solution exists. The challenge will be to transfer it to professionals in this field and to the public. Again, an internet based knowledge platform could be a first right move. It could for instance also include possibilities for training, teaching or mediating teachers. The first two steps will be the precondition for the third: determining tasks for research and quality asscurance. To improve care in Geriateric Psychiatry, the EAGP will have to communicate this three-step model to the population, the professionals working in the field and to european and national governments.

SS-07-02

Skill-based objectives for specialist training in old age psychiatry

R. Mateos. Psychogeriatric Unit of the CHUS University Hospital, Santiago de Compostela, Spain

The four Technical Consensus Statements on Psychiatry of the Elderly produced at meetings organized by WHO and WPA since 1996 are the general background of this document. This consensus curriculum on Skill-Based Objectives in Old Age Psychiatry (OAP) is the result of a process initiated by the European Association of Geriatric Psychiatry (EAGP), and jointly organized with the World Health Organization (WHO) and by the World Psychiatric Association (WPA) Section of Psychiatry of the Elderly. It was developed at the meeting “Development of Strategies, Policies and Actions in Education and Training in Old Age Psychiatry in Europe” (Prilly/Lausanne, 8-11 June 2002) and published in 2003 after a thorough consultation process with multidisciplinary experts in the field. The participants represented important international associations as well as individual professional experience in OAP in different European countries. The aim of this Curriculum document is to provide a practical tool by outlining a framework to train leaders in the provision of comprehensive specialist mental health services for older people as recommended in the previous WHO/WPA consensus statements. The curriculum is formulated in terms of 22 areas of competence each of which is divided into a number of assessable learning objectives. The curriculum content described is intended to provide overall guidance as to the content of training programmes. It is not however either proscriptive or exhaustive. There is clearly a need to adapt it to ensure local relevance and feasibility. The final goal is that this curriculum will form a constructive basis for the setting up of supra-specialist training courses and clinical attachments in the psychiatry of old age. In this context, it is recommended that all European countries should set up national systems to accredit such supraspecialists.

SS-07-03

Late-life depression as a cause of social disability

J. Leszek. Wroclaw, Poland

Epidemiological date consistently show that depression affects about 15% of older people, making it the most common mental health problem of older people. Despite its prevalence and seriousness, depression in late life remains underappreciated as a source of disability and suffering for older people and their families. Depression remains central concern to older people, their families, and the clinicians who take care of them. Even when it appears to be an understandable response to illness, the onset of depression should be viewed as a sentinel event that increases the risk for subsequent declines in health status and functional ability. In opinion of author's, early recognition, diagnosis, and initiation of treatment of depression in older persons present opportunities for improvements in quality of life, the prevention of suffering or premature death,and the maintenance of optimal levels of function and independence for older people. Thus, generally increasing the awareness and education of the significance of depression and its sequelae in old age population may help improve recognition and treatment.

SS-07-04

Romanian perspectives on old age psychiatry

N. Tataru. Romania

Objective: In Romania like in other parts of the world, the geriatric psychiatry is still not enough represented. The number of professionals working in the field is still very low to satisfy the needs of care of elderly with mental disorders. Romanian Geriatric Psychiatry Association, trys to improve this situation organizing the training under and post-graduate courses for young doctors. Specialist education and training in OAP has also to help develop the competencies of professionals in Europe to: promote mental health in old age, prevent mental disorders, care for older people with mental health problems, provide public and trans-disciplinary information about mental health in old age, reduce stigma and discrimination. In spite of the professionals' endeavor specializing in the teaching and educational program, there exist only a few psychogeriatric services and less special care services for dementia patients. Only presently, in our country we started to add at traditional system of active hospital care the community health care services. This allows the combination treatment of elderly in their homes, in day-care centres or others care provider services. This system need the formation of multidisciplinary community mental health teams, that should adapt their care according to attenders' needs changed over time.

Conclusion: The extension of outreach services of nursing homes and residential homes in conjunction with day-care centres, day hospitals and residence care could be a valuable alternative to the high degree of institutionalization of elderly people with or without mentally disorders.

SS-07-05

An initiative to promote exchange between professionals in old age psychiatry

M. Aartsen. Knowledge Center of Psychiatry in the Elderly, Zeist, Netherlands

The Knowledge Centre of Psychiatry in the Elderly is located in the Netherlands and was officially established in September 2003. The two chairs of old age Psychiatry in the Netherlands took the initiative to open the centre. It is a collaboration of Altrecht mental health care, University of Utrecht, Buitenamstel mental health care, and the Free University Amsterdam, and is recognised and subsidised by the Dutch Ministry of Health, Welfare and Sports. The Centre aims at improving the quality of care of elderly people with psychological and psychiatric problems and targets the needs of both the professional and the general public. We are building a requirement-oriented knowledge network of psychiatry of the elderly in harmony with relevant partners in this field, both within and outside of the Netherlands. The network is to have a binding function between research and practice questions. The Knowledge Centre of Psychiatry in the Elderly has recently started the Cohort study of Psychiatry of the Elderly. The scientific knowledge in Dutch Psychiatry of the Elderly offers relatively limited research data about the large group of elderly requiring help from the mental health care body. In order to realise well-founded assistance in daily practice, more knowledge about this group is essential. The cohort study aims at providing more insight into the characteristics of the older mental health care population. For instance, how do the findings in population cohorts concerning risk factors, course, and determinants for functioning relate to those in a mental health care cohort? Or what are the determinants for requests for help? In order to provide an answer to these questions, more insight into the characteristics of the older mental health care population is required. In this study we will seek collaboration with European partners in order to reveal the differences and corresponding views of the psychiatric care in the various European countries.