Improving Access to Mental Health Care in Residents of Long-Term Care Living Facilities.

Abstract

Objective: Residents of long-term care facilities have reduced access to mental health care due to the availability of providers, transportation, and staff or family members who must accompany the resident. As a result, many residents wait up to 6 months for a first appointment with a psychiatric provider or utilize their primary care provider to meet their mental health care needs.

Methods: To increase access to mental health care, tablets were placed in long-term care facilities to access telehealth visits with mental health providers. Psychiatric visits were conducted via telehealth to assess, diagnose, and treat residents of the facilities. Psychiatric Mental Health Nurse Practitioners also worked to ensure the correct diagnosis and treatment were applied to each resident. In addition, there was a focus on prescribing psychotropic medications such as antipsychotics and benzodiazepines only when clinically indicated and at the lowest effective doses and ensuring gradual dose reduction efforts were being conducted safely.

Results: Results of this project showed a decrease in time to first appointment from 6 months to 20 days, an increase in the application of clinical criteria to determine diagnoses, improvement in initiating gradual dose reduction requirements when clinically indicated, and resident, staff, and family satisfaction with care.

Conclusions: The results of this project show that it is feasible and safe to provide mental health visits to residents of long-term care facilities through telehealth and should be considered to improve access to mental health care services for this population.