Over 2300 patients referred to a geriatric outreach program were evaluated for the relationships between diagnosis and (1) referral reason, (2) referral source, and (3) age. Referral reason was only a clue to the eventual diagnosis. Patients referred for depression received a diagnosis of depression in only 46 per cent of such referrals, and patients referred for forgetfulness or confusion received a diagnosis of dementia in only 37 per cent of these referrals. Families were most likely to refer demented patients, and health agencies to refer depressed patients. Apartment managers and housing authority representatives were least likely to refer depressed patients and most likely to refer paranoid patients. The rate for diagnosis of dementia increased with age, whereas the rates for diagnoses of depression and alcohol/drug abuse decreased with age.
Teams of state and local agency professionals responsible for mental health and aging services participated in a model project utilizing education and consultation to facilitate community mental health programming for the elderly. Participants identified both anticipated and actual barriers to programming. Competing program priorities and lack of staff knowledge about mental health and aging were anticipated and confirmed as major barriers. Agency-organizational barriers were unanticipated, yet there were severe problems in cooperative interagency programming.
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