The needs of older people with mental health problems in a Portuguese psychiatric setting

Int Psychogeriatr. 2017 May;29(5):845-853. doi: 10.1017/S1041610217000072. Epub 2017 Feb 8.

Abstract

Background: This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems.

Methods: A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE.

Results: The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients' main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = -8.58, p < 0.001; Z = -11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients.

Conclusions: Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients' perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.

Keywords: CANE; elderly; geriatric psychiatry; mental health; needs assessment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / psychology*
  • Dementia / epidemiology*
  • Depressive Disorder / epidemiology*
  • Female
  • Geriatric Assessment
  • Health Services Needs and Demand*
  • Health Services for the Aged / organization & administration
  • Humans
  • International Classification of Diseases / standards
  • Male
  • Mental Health Services / organization & administration
  • Needs Assessment
  • Portugal / epidemiology
  • Psychiatric Status Rating Scales
  • Schizophrenia / epidemiology*