This study found lower levels of severe mental health problems, especially depression, than reported elsewhere, but higher prevalence of psychological distress. High levels of physical and mental health co-morbidity were found. These findings suggest that planning for primary care services needs to adopt a flexible assessment model. The development of effective, time-limited protocols and screening tools to assist the PHCT in improving their identification rates is recommended. This needs to be supported by the availability of appropriate treatments for the psychological distress.

SUMMARYOne hundred and thirty residents of 11 Part 111 homes who had been in care for a year or more and had no cognitive impairment as assessed by the Crichton Royal Behavioural Rating Scale were investigated using the Clinical Interview Schedule, the 10-question Mental Test Score and standardized schedules for aphasia and parietal lobe function. Thirty per cent showed signs of early dementia; mild to moderate neurotic symptoms were common among the remainder. Ten per cent had longstanding impairment of intellect or personality or were schizophrenic. Less than 15% warranted a diagnosis of neuritic depression or anxiety. Most of this psychopathology was regarded as 'normal' by senior staff. Relatively well-preserved 'clients' presenting as 'in need of care' should receive particularly careful attention when formal assessment is reintroduced as a requirement before placement into rest homes at public expense. Those failing because of mildlmoderate dementia are likely to benefit from admission while others may find life in care frustrating and depressing.

No abstract

No abstract

No abstract