Training Geriatric Psychiatry Fellows in the Medicolegal Aspects of Psychiatric Consultation in the Nursing Home

Abstract

Accredited fellowship training programs in geriatric psychiatry are required to address ethical and legal issues pertaining to mental health in older adults, and to provide clinical experiences that enable trainees to develop competencies in long-term care consultation. The growing number of criminal offenders with mental illness and other disabling conditions that require long-term care, along with comprehensive federal regulations that affect mental health care in nursing homes, is creating a more urgent public health need to train psychiatrists with specific competencies in patient care, interpersonal skills and communication, and systems-based practice as they apply to medicolegal aspects of psychiatric consultation in the nursing home setting. This article reviews legal and regulatory information that is pertinent to training fellows in the care of elderly nursing home residents with mental illness or behavioral problems. It describes several aspects of the Geriatric Psychiatry Fellowship Training Program at the University of Pennsylvania that promote development of skills in geriatric psychiatry consultation in nursing homes.