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At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
"In this in-depth critique of the mental healthcare system, a leading advocate for the mentally ill argues that the system fails to adequately treat the most seriously ill. He proposes major reforms to bring help to schizophrenics, the severely bipolar, and others"--
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
In late 2003, inspired by the recommend. of the Pres.¿s New Freedom Comm. on Mental Health, the Bazelon Center for Mental Health Law undertook a study of board & care homes for people with psychiatric disabilities. A draft report was produced, then on Nov. 18 & 19, 2004, the Bazelon Center hosted a nat. strategy meeting to discuss the findings. This final report incorp. the discussion & recommend. from the Nov. 2004 meeting. It discusses the impact of short-term quality improvement measures in the use of board & care homes. It also calls for a fresh approach to providing housing for people with psychiatric disabilities -- a recovery-oriented approach that revolves around the principles of consumer self-direction & community integration.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.
The care home sector is large, with over 400 000 residents in the UK and a similar number employed within the homes. It is therefore an area of considerable economic importance. Care home residents are often very old, and many have multiple physical and mental health needs, meaning that their care poses particular challenges. They are also a distinctly and profoundly marginalised group who are often invisible in the wider debates on quality of care including those about care homes. Mental Health and Care Homes is a coherent and evidence-based text exploring these issues. Bringing together both clinical and research perspectives it will help those working in the care home sector to deliver high quality care and support to both residents and staff. This important, yet neglected, area is thoroughly reviewed by a range of experts including residents, family carers, staff, researchers, and clinicians. The book has four sections: 'the inside view' which includes several first-hand accounts of care home life; 'the outside view' which discusses the regulatory, funding, and legislative context in which care homes operate; 'mental health and care', a detailed review of the major mental and other health issues that arise in care homes, as well as interventions and services to offer support; and a section exploring the 'promotion of health and wellbeing' including examples of good practice. It concludes by synthesising key themes and setting an agenda for further enquiry. The book is written in a style that encourages engagement, with the inclusion of contemporary case studies and examples, making it topical and readable. It will be valuable for a broad professional and vocational audience across both health and social care, as well as students and researchers.