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This project evaluated a method for improving the quality of home and community-based care of older persons with mental disorders by using an integrated assessment, outcome measurement, and treatment planning methodology (the Outcome-based Treatment Plan or OBTP) specifically designed for this population. The study investigated whether this comprehensive system could improve clinicians' ability to recognize and treat mental illness in older adults. Further, it investigated whether the consistent use of a set of tools specifically designed for this population (the OBTP) could both inform treatment and give policymakers important data concerning treatment effectiveness.
The study found that the use of OBTP resulted in:
- More comprehensive and specific assessment of client mental health and functional status
- Increased documentation of the severity of the client's symptom and functional problems
- Greater documentation of progress over time in all symptom and functioning areas
- An increase in the number and specificity of documented services
- Heightened client satisfaction with the extent that the mental health services had helped them with their problems and their overall quality of life
Implementation of the OBTP could lead to improved understanding of older adults with serious mental illness and help address clinicians' generally low level of understanding regarding this population. By helping clinicians to assess and treat OSMI more appropriately, the OBTP could lead to improved health and quality of life and help reduce avoidable service utilization.
Publications
Bartels, S.J., Miles, K.M., and Dums, A. R. 2002.
Policy Brief: Improving the Quality of Care for Older Adults with Mental Disorders: The Outcomes-Based Treatment Planning System of the NH-Dartmouth Psychiatric Center.
NY: Home Care Research Initiative, Center for Home Care Policy and Research, Visiting Nurse Service of NY.
Bartels, S.J., Miles, K.M., and Dums, A.R. 2001.
"Improving Routine Geropsychiatric Assessment and Treatment Practices by Mental Health Providers: A Controlled Comparison Study."
Under Review.
Bartels, S.J., Levine, K.J., and Sea, D. 1999.
"Community-based long-term care for older persons with severe and persistent mental illness in an era of managed care."
Psychiatric Services, 50(9): 1189-1197.
Jeste, D.V., Alexopoulos, G.S., Bartels, S.J.,et al. 1999.
"Consensus statement on the upcoming crisis in geriatric mental health."
Archives of General Psychiatry, 56: 848-853.
Bartels S.J., Miles K.M., Levine K., Horn S., Sharkey P., and Joyce T. 1997.
"Improving psychiatric care of the older patient."
In S.D. Horn (Ed.). Clinical Practice Improvement Methodology: Effective Evaluation and Management of Health Care Delivery, NY: Faulker and Gray, 193-217.
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