Mental health service use by the elderly in nursing homes.

Journal Article (Journal Article)

OBJECTIVES: Because current Omnibus Budget Reconciliation Act regulations influence the disposition of US nursing home residents who have mental illness, National Nursing Home Survey (1985) data are analyzed for predictors of mental health service use. METHODS: Elderly residents' rates of mental health service use are presented. Logistic regression yielded odds ratios for treatment by both mental health specialists and general practitioners for client and service system variables. RESULTS: Among the two thirds of elderly residents with a mental disorder (including dementia), only 4.5% receive any mental health treatment in a 1-month period. The ratio of specialist to general practitioner care is approximately 1:1. Patients seen by a specialist are likely to be younger (aged 65 to 74); live in the Northeast; and have a diagnosis of schizophrenia (13:1), dementia (3:1), or other mental disorders (5:1). Prior residence in a psychiatric hospital predicts care by both health professional types. Rural location, nonproprietary ownership of the nursing home, and aggressive behavior point to general physician care. CONCLUSIONS: Our findings indicate significant neglect of the mental health needs of older nursing home residents and underscore the importance of monitoring the regulations for screening and treatment of mental disorders under the Omnibus Budget Reconciliation Act.

Full Text

Duke Authors

Cited Authors

  • Burns, BJ; Wagner, HR; Taube, JE; Magaziner, J; Permutt, T; Landerman, LR

Published Date

  • March 1, 1993

Published In

Volume / Issue

  • 83 / 3

Start / End Page

  • 331 - 337

PubMed ID

  • 8438968

Pubmed Central ID

  • PMC1694647

International Standard Serial Number (ISSN)

  • 0090-0036

Digital Object Identifier (DOI)

  • 10.2105/ajph.83.3.331


  • eng

Conference Location

  • United States