Understanding working-age adults with mental illness living in nursing homes

了解居住在疗养院的患有精神疾病的工作年龄成年人

基本信息

批准号：
9762208
负责人：
Kate L Lapane
金额：
$ 20.94万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-13 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9762208
关键词：
Address Adult Age Age-Years Amendment American Americans with Disabilities Act Anxiety Disorders Area Caring Certification Characteristics Clinical assessments Communities Data Data Collection Data Set Diagnosis Discipline of Nursing Discrimination Effectiveness Ensure Foundations Health Health Services Needs Health care facility Home Nursing Care Home environment Impaired cognition Individual Institutionalization Knowledge Length of Stay Link Long-Term Care Longitudinal observational study Medicaid Medicare/Medicaid Mental Depression Mental Health Services Mental disorders Modeling National Institute of Mental Health Nursing Homes Nursing Services Ownership Patients Population Post-Traumatic Stress Disorders Prevalence Process Provider Psychiatric Hospitals Psychiatric therapeutic procedure Psychotic Disorders Quality of Care Quality of life Questionnaires Reporting Research Resort Schizophrenia Services Source Subgroup Supreme Court Decisions Surveys System United States Dept. of Health and Human Services Vulnerable Populations Work aged clinical care community based care community based service experience falls improved instrument medical specialties neglect prevent programs screening severe mental illness young adult

项目摘要

PROJECT SUMMARY/ABSTRACT The 1990 Americans with Disabilities Act (ADA), 1999 Olmstead Supreme Court Decision, and ADA Amendments Act of 2008 are supposed to protect people with serious mental illness (SMI) against discrimination by considering institutionalization as the last resort to be used only if integrated community-based services are not a viable alternative. Despite these federal mandates, nursing homes may have replaced state psychiatric hospitals as the default source of care. Nursing homes now serve more adults with mental illnesses than all other healthcare facilities combined. Between 10-25% of nursing home residents are thought to have SMI. Residents with SMI are often younger than the typical resident and require services that nursing homes might not be able to provide. Knowledge is lacking about the current extent of this potential warehousing of working-age adults with SMI. We propose using data from the 2011-2016 federally mandated, longitudinal Minimum Data Set 3.0 and Certification and Survey Provider Enhanced Reporting files to conduct an observational longitudinal observational study of adults between the ages of 22 and 64 years with SMI residing in nursing homes. Our specific aims are to: 1) estimate the overall prevalence of SMI among these working-age nursing home residents and to describe the length of stay by psychiatric disorder; 2) examine receipt of psychiatric treatment for these residents; and 3) use latent variable models to identify distinct subgroups of functioning among those with SMI and describe relationships between these subgroups, resident and facility characteristics, and disposition status. This proposal addresses the National Institute of Mental Health’s Strategic Objectives 2: to chart mental illness trajectories to determine when, where, and how to intervene and 4.1: to improve the efficiency and effectiveness of existing mental health services through research. This exploratory research will inform efforts to improve the delivery of mental health services to a particularly vulnerable population by illuminating the current care needs of working-age adults with mental illness.

项目概要/摘要 1990 年《美国残疾人法案》(ADA)、1999 年奥姆斯特德最高法院判决和 ADA 2008 年修正案旨在保护患有严重精神疾病 (SMI) 的人免受歧视考虑将制度化作为最后手段，只有在综合社区服务得以实现的情况下才可使用尽管有这些联邦规定，疗养院可能已经取代了州精神病院。医院作为默认的护理来源，现在为患有精神疾病的成年人提供服务。医疗保健机构中 10-25% 的疗养院居民被认为患有 SMI。患有 SMI 的人通常比一般居民年轻，并且需要疗养院可能无法提供的服务目前对工作年龄成年人的潜在储存程度缺乏了解。我们建议使用 2011-2016 年联邦政府规定的纵向最小数据集 3.0 的数据。认证和调查提供商增强报告文件以进行纵向观察对居住在疗养院的 22 岁至 64 岁患有 SMI 的成年人进行的观察性研究。具体目标是： 1) 估计这些工作年龄疗养院居民中 SMI 的总体患病率并描述精神疾病的住院时间；2) 检查接受的精神治疗居民；3) 使用潜在变量模型来识别 SMI 患者的不同功能亚组并描述这些亚组、居民和设施特征以及处置状态之间的关系。该提案涉及国家心理健康研究所的战略目标 2：绘制精神疾病图表确定何时、何地以及如何进行干预的轨迹 4.1：提高效率和效果这项探索性研究将为改善现有的精神卫生服务提供信息。通过阐明当前的护理需求，向特别弱势群体提供心理健康服务患有精神疾病的工作年龄成年人。