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|Van Citters, A. D., & Bartels, S. J. (2004). A systematic review of the effectiveness of community-based mental health outreach services for older adults. Psychiatric Services, 55(11), 1237-1249.
|community-based mental health outreach services, mental health, older adults, psychiatric outreach services, psychiatric, mental illness, community mental health services, mental disorders outreach programs
|Background: Research suggests that older adults underutilize mental health services compared to other groups. Many professionals and advocacy groups have recommended mental health outreach programs to improve the participation of older adults in community-based programs. However, there has not been a systematic review of the effectiveness of mental health outreach services for this population.
Objectives: To assess the research evidence on outreach services for older adults with mental health impairments living in community-based environments.
Search strategy: The authors searched MEDLINE, CINAHL, PsycINFO, and Web-of-Science databases for articles written in English. The authors considered articles that were published through May 2004.
Selection criteria: The authors included research studies on mental health care providers and consumers (age 65 and older). Study designs included randomized controlled trials, quasi-experimental studies, uncontrolled cohort studies, or comparisons of two or more interventions. All studies were conducted in community-based or other non-institutional settings. Outcome measures of interest included access to services and psychiatric outcomes.
Results: The authors identified 14 studies that were appropriate for the review from a collection of 145 articles. Two studies (one controlled prospective study and one study that used a comparison group) found support for the use of gatekeepers (i.e., community service personnel who have frequent contact with consumers) in identifying and assisting older adults with mental illness who are socially isolated. Twelve studies (five randomized controlled trials, one quasi-experimental study, and six uncontrolled cohort studies) focused on treatment effectiveness. The treatment effectiveness studies indicate community-based mental health treatment can improve psychiatric outcomes, including depressive symptoms. One study reported improved overall psychiatric symptoms. However, statistical aggregation of data from the 12 studies was not conducted due to the variability of research designs and methods.
Conclusions: While providing supportive evidence, only two studies were identified that focused on the effectiveness of outreach services in identifying isolated older adults with mental illness. There is more research evidence on the effectiveness of community-based mental health treatment in improving psychiatric symptoms. More rigorous research is needed on mental health treatment among older adults that considers the wide range of mental illness.
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