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Two-Minute Mental Health Care for Elderly Patients: Inside Primary Care Visits.
- Source :
- Journal of the American Geriatrics Society; Dec2007, Vol. 55 Issue 12, p1903-1911, 9p, 1 Diagram, 4 Charts
- Publication Year :
- 2007
-
Abstract
- OBJECTIVES: To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. DESIGN: Mixed-method observational analysis of the nature of the topics discussed, content of discussion, and the time spent on mental health. SETTINGS: Three types of settings: an academic medical center, a managed care group, and fee-for-service solo practitioners. PARTICIPANTS: Thirty-five primary care physicians and 366 of their elderly patients. MEASUREMENTS: Videotapes of 385 visits covering 2,472 diverse topics were analyzed. Coding of the videotapes identified topics, determined talk time, and coded the dynamics of talk. RESULTS: Mental health topics occurred in 22% of visits, although patient survey indicated that 50% of the patients were depressed. A typical mental health discussion lasted approximately 2 minutes. Qualitative analysis suggested wide variations in physician effort in providing mental health care. Referrals to mental health specialists were rare even for severely depressed and suicidal patients. CONCLUSION: Little time is spent on mental health care for elderly patients despite heavy disease burdens. Standards of care based on a count of visits “during which a mental health problem is discussed” may need to be supplemented with guidelines about what should happen during the visit. System-level interventions are needed. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 55
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 27727561
- Full Text :
- https://doi.org/10.1111/j.1532-5415.2007.01467.x