Veterans Affairs Intensive Case Management for older veterans

Area of Science:

• Geriatric psychiatry
• Mental health services research
• Evidence-based practice

Background:

• Growing need for evidence-based practices for elderly individuals with severe mental illness (SMI).
• Focus on community-based services like assertive community treatment (ACT).

Purpose of the Study:

• Examine age distribution, needs, service delivery, and outcomes for elderly veterans in an ACT-based program.
• Characterize the unique profile of older adults with SMI in a community treatment setting.

Main Methods:

• Analysis of national evaluation data (2001-2005) from Veterans Affairs Mental Health Intensive Case Management (MHICM) program (N=5,222).
• Characterization of participants by age, needs, service patterns, and treatment outcomes.

Main Results:

• 24.8% of participants were 55-64, 7.4% 65-74, and 2.8% over 75.
• Older veterans (over 75) had later onset, nonpsychotic illnesses, less substance abuse, and limited hospital treatment.
• Older veterans were less symptomatic, more socially satisfied, received fewer recovery-oriented services, and more crisis/medical services.

Conclusions:

• Older veterans in ACT-like services are a distinct group with late-onset problems, not just aged young patients.
• Need for greater focus on recovery-oriented services and community support for this subgroup.
• MHICM services may facilitate community living, reduce hospitalizations, and alleviate family burden.