Integrated physical and mental healthcare for older adults in Europe: from concept to implementation-a joint EuGMS and EAGP perspectives paper.

Abstract

Older adults commonly experience coexisting mental and physical multimorbidity, alongside frailty and polypharmacy. This clinical complexity is associated with poorer health outcomes, including higher rates of acute hospital admission, longer lengths of stay, increased dependency at discharge and higher mortality. Despite this, physical and mental health services for older adults are fragmented across Europe, often operating in a parallel rather than integrated manner. As a result, many patients receive poorly coordinated care. In response, there is growing interest in the development of integrated care services for these patients across Europe. Although a range of service models have been proposed, what constitutes "best practice" remains unclear and is likely to depend on local population needs, service configuration, healthcare context and healthcare workers education. The European Geriatric Medicine Society and European Association of Geriatric Psychiatry have initiated a Task and Finish Group to develop expert-based recommendations for integrated physical-mental health services for older adults across Europe. In this perspectives paper we consider the challenges associated with delivering integrated physical-mental healthcare for older adults, drawing on clinical and service level observations. We suggest that current approaches to integrated care are often limited in scope and variability and may not fully address the needs of older adults with combined physical and mental illness. A broader conceptualisation of integration may be required. We outline implications for future research, service development, and policy, with a focus on improving alignment between healthcare systems to address the needs of this growing population. This work was endorsed by the European Geriatric Medicine Society.