Psychiatric Services: Experience, Perceptions, and Needs of Nursing Facility Multidisciplinary Leaders

Muramatsu, Russ S.; Goebert, Deborah

doi:10.1111/j.1532-5415.2010.03205.x

Cited by 12 publications

(13 citation statements)

References 28 publications

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“…Nursing homes in the United States haves long been functioning in a way that focuses on the management of chronic medical conditions and disabilities, largely ignoring the psychosocial needs of residents. As a result, many nursing homes lack the necessary resources, expertise, and financial incentives to serve residents with behavioral health issues appropriately (Li, 2010; Muramatsu & Goebert, 2011; Reichman et al, 1998). This issue is particularly salient for nursing homes predominated by racial and ethnic minorities, which are oftentimes low-resource and poor-staffed facilities (Fennell et al, 2010; Li, Harrington, Mukamel, et al, 2015; Li, Harrington, Temkin-Greener, et al, 2015; Mor et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…The estimated rates of diagnosed depression among nursing home residents are higher than the estimated rates for elderly persons living in the community, which generally range between 5% and 10% (Akincigil et al, 2012; Crystal et al, 2003). The elevated burden of depression among nursing home residents is further complicated by their severe physical and cognitive impairments, their complex clinical and nursing care needs, and the inability of many nursing homes to provide adequate psychiatric services (Li, 2010; Muramatsu & Goebert, 2011; Reichman et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents

Cai

Harrington

et al. 2018

Journal of Aging & Social Policy

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This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score ≥ 10 on the 9-item Patient Health Questionnaire [PHQ-9] scale) and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents. We found that the prevalence rate of PHQ-9 scores ≥ 10 was 8.8% among non-Hispanic White residents (n = 653,031) and 7.4%, 6.9%, and 6.6% among Black (n = 97,629), Hispanic (n = 39,752), and Asian (n = 16,636) residents, respectively. The reduced likelihoods of significant depressive symptoms for minority residents compared to non-Hispanic Whites persisted after sequential adjustments for resident and nursing home covariates, as well as in stratified analyses. The persistently lower rate of significant depressive symptoms among racial and ethnic minority residents suggests that training of nursing home caregivers for culturally sensitive depression screening is needed for improved symptom recognition among minority residents.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents

Cai

Harrington

et al. 2018

Journal of Aging & Social Policy

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“…NHs' perceptions of BH service availability were assessed in two survey questions: one asking about the degree of difficulty the NH has in providing BH services, and another regarding the extent to which NHs consider various aspects of the admission process when admitting patients with a recent history or current diagnosis of psychiatric/behavioral problems …”

Section: Methodsmentioning

confidence: 99%

Providing Behavioral Health Services in Nursing Homes Is Difficult: Findings From a National Survey

Orth

Simning

et al. 2019

J American Geriatrics Society

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OBJECTIVES Behavioral health (BH) disorders affect 65% to 90% of nursing home (NH) residents. Access to BH services in NHs has been generally considered inadequate, but the empirical evidence is sparse. We examined the availability of BH services and identified facility‐level factors associated with the difficulty of providing BH services in NHs. DESIGN A national random sample of 3996 NHs was identified. Two structured surveys with questions about BH service availability, quality, satisfaction, staffing, staff education, turnover, and service barriers were mailed to administrators and directors of nursing in each NH between July and December 2017. SETTING/PARTICIPANTS Completed surveys were obtained from 1079 NHs (27% response rate). Descriptive statistics and multivariable logistic regressions were employed. MEASUREMENTS Four outcome measures were based on five‐point Likert scales: (1) adequacy of BH staff education; (2) ability to meet resident BH service needs; (3) adequacy of coordination/collaboration between NH/community providers; and (4) availability of necessary facility infrastructure. RESULTS BH service needs were unmet in one third of NHs; almost half lacked appropriate staff BH education. Over 30% reported having inadequate coordination of care between NH and community providers, and 26.2% had inadequate infrastructure for residents' referrals/transport. Staff BH education was less problematic in NHs with Alzheimer disease units (odds ratio [OR] = 0.6; P < .05), lower registered nurse (RN) turnover (OR = 0.7; P < .05), and more psychiatrically trained RNs (OR = 0.5; P < .001) and social workers (OR = 0.6; P < .05). Lower RN turnover (OR = 0.7; P < .05) and more psychiatrically trained RNs (OR = 0.6; P < .05) were associated with fewer NHs reporting being unable to meet BH service needs. Having more psychiatrically trained RNs (OR = 0.6; P < .05) was associated with fewer NHs reporting inadequate coordination with community providers. CONCLUSION Inadequate BH education and psychiatric training among NH staff were associated with subpar provision of BH services in this care setting. New initiatives that increase access to BH providers and services and improve staff education are urgently needed in NHs. J Am Geriatr Soc 67:1713–1717, 2019

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“…However, while individuals who move into a NH have significant physical health needs and functional limitations, those who also have a mental health diagnosis, including anxiety, bipolar, and/or schizophrenia, and receive Medicaid have compounded needs and challenges. For example, Muramatsu and Goebert (2011) reported a number of challenges associated with treating those with mental health concerns in a NH, including concerns regarding dangerousness, the need for greater staff attention, and lack of trained staff as well as difficulties with accessing psychiatric support and rehospitalization. Further, Meador et al (2011) found that older adults receiving Medicaid services are less likely to be discharged from a NH to a community setting due to limited available resources.…”

Section: Successful Strategies For Discharging Medicaid Nursing Home mentioning

confidence: 99%

Successful Strategies for Discharging Medicaid Nursing Home Residents With Mental Health Diagnoses to the Community

Leedahl¹,

Chapin²,

Wendel³

et al. 2014

Journal of Social Service Research

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Psychiatric Services: Experience, Perceptions, and Needs of Nursing Facility Multidisciplinary Leaders

Cited by 12 publications

References 28 publications

Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents

Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents

Providing Behavioral Health Services in Nursing Homes Is Difficult: Findings From a National Survey

Successful Strategies for Discharging Medicaid Nursing Home Residents With Mental Health Diagnoses to the Community

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