Abstract
Nearly a third of patients seen by providers in home-based primary care are likely to have significant mental health problems, the most common of which is major depression. In general, these conditions are under-recognized and undertreated. Providers should screen for common mental health conditions, understand basics of diagnosis for key types of illnesses, and be familiar with the options for treatment, including community resources and medications. This chapter reviews practical approaches including assessment, diagnostic criteria, interplay of medical and psychiatric conditions, tables to guide medication selection, how to manage difficult situations, and patient and provider safety.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Davitt JK, Gellis ZD. Integrating mental health parity for homebound older adults under the Medicare home health care benefit. J Gerontol Soc Work. 2011;54:309–24.
Kroenke K, Spitzer RL, Williams JB. The patient health questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.
Counsell SR, Callahan CM, Clark DO, et al. Geriatric care management for low-income seniors: a randomized controlled trial. JAMA. 2007;298:2623–33.
England MJ, Butler AS, Gonzalez ML. Psychosocial intervention for mental and substance use disorders: a framework for evidence-based standards. Institute of Medicine of the National Academies. Washington, DC: National Academies Press; 2015. Downloaded at http://books.nap.edu/openbook.php?record_id=19013&page=R1
Stergiopoulos V, Hwang SW, Gozdzik A, Nisenbaum R, Latimer E, Rabouin D, Adair CE, Bourque J, Connelly J, Frankish J, Katz LY, Mason K, Misir V, O’Brien K, Sareen J, Schütz CG, Singer A, Streiner DL, Vasiliadis HM, Goering PN, for the At Home/Chez Soi Investigators. Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: a randomized trial. JAMA. 2015;313(9):905–15. doi:10.1001/jama.2015.1163.
Bruce ML, Raue PJ, Reilly CF, Greenberg RL, Meyers BS, Banerjee S, Pickett YR, Sheeran TF, Ghesquiere A, Zukowski DM, Rosas VH, McLaughlin J, Pledger L, Doyle J, Joachim P, Leon AC. Clinical effectiveness of integrating depression care management into Medicare home health: the depression CAREPATH randomized trial. JAMA Intern Med. 2015;175(1):55–64. doi:10.1001/jamainternmed.5835.
Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ. 2015;2015:350–69. doi:10.1136/bmj.h369.
England MJ, Butler AS, Gonzalez ML. Psychosocial intervention for mental and substance use disorders: a framework for evidence-based standards. Institute of Medicine of the National Academies. Washington, DC: National Academies Press; 2015. Downloaded at http://books.nap.edu/openbook.php?record_id=19013&page=R1 (Op Cit.).
Schneider LS, Tariot PN, Dagerman KS, Davis SM, Hsiao JK, Ismail MS, Lebowitz BD, Lyketsos CG, Ryan JM, Stroup TS, Sultzer DL, Weintraub D, Lieberman JA, CATIE-AD Study Group. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med. 2006;355(15):1525–38.
Wang PS, Schneeweiss S, Avorn J, Fischer MA, Mogun H, Solomon DH, Brookhart MA. Risk of death in elderly users of conventional vs. atypical antipsychotic medications. N Engl J Med. 2005;353:2335–41.
Jeste DV, Blazer D, Casey D, Meeks T, Salzman C, Schneider L, Tariot P, Yaffe K. ACNP white paper: update on use of antipsychotic drugs in elderly patients with dementia. Neuropsychopharmacology. 2008;33:957–70.
Porsteinsson AP, Drye LT, Pollock BG, Devanand DP, Frangakis C, Ismail Z, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA. 2014;311(7):682–91.
Mueser KT, Bond GR, Drake RE, Resnick SG. Models of community care for severe mental illness: a review of research on case management. Schizophr Bull. 1998;24(1):37–74.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Boling, P.A., Hardy, L.T., Crouse, E.L. (2016). Adult Psychiatric Care in the Home. In: Hayashi, J., Leff, B. (eds) Geriatric Home-Based Medical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-23365-9_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-23365-9_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-23364-2
Online ISBN: 978-3-319-23365-9
eBook Packages: MedicineMedicine (R0)