"We often get discouraged that the most vulnerable people are the least likely to benefit from care -- that's clearly not the case here."
In the case of older adults with psychiatric problems, a four-year Johns Hopkins study has shown that a program combining observations by janitors, building managers and others who frequently see elderly people and the skills of a highly accessible psychiatric nurse can significantly increase seniors' mental health and stability.
The research, reported in today's Journal of the American Medical Association, highlights the first large-scale, low-cost, medically successful approach to the dilemma that elderly people on their own are far less likely to be diagnosed or treated for mental illness than younger adults, according to psychiatrist Peter Rabins, M.D., who directed the study.
Elderly people are less likely to get treated for mental illness for a host of reasons, Rabins says: "Their generation's reluctant to admit to mental health problems; they may have insufficient insurance or even a simple lack of transport to the doctor's office. No single solution tackles all the reasons," he adds, "but this new program, based on quickly recognizing mental problems and improving access to care shows large populations can be helped affordably."
In a test of the PATCH program --for Psychogeriatric Assessment and Treatment in City Housing --involving 945 senior residents of six public housing sites in Baltimore, residents in the three test sites scored 17 percent higher in a test of general mental health than those in the three sites without it. The PATCH group also scored 32 percent lower on a standard test measuring depression.
"We often get discouraged that the most vulnerable people are the least likely to benefit from care-- that's clearly not the case here," says Rabins.
Though still experimental, PATCH has proved so successful that it now operates in every public housing site in Baltimore, Rabins says.
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Contact: Marjorie Centofanti
mcentofanti@jhmi.eu
410-955-8725
Johns Hopkins Medical Institutions
6-Jun-2000