A mental health assessment and support team for community elders in Fife (EAST)

The aging population combined with the increased recognition of the need to assess elderly patients with mental health difficulties in their own environment encouraged service redesign in Fife with the focus on community assessment of older people with mental health needs.

To establish and assess the functioning of a joint Health and Social Services enhanced assessment and support team (EAST) for community-dwelling elders with significant mental health needs living in a Scottish health region, and to determine the impact of this team on the requirement for acute psychogeriatric hospital services.

Prospective three-year data collection of service activity involving EAST and the local psychogeriatric acute inpatient and day hospital facilities.

EAST assessed 111 patients during the study, 83% with a diagnosis of dementia. The mean duration of assessment was six weeks with 9% of patients receiving an overnight home assessment and 6% requiring hospital admission. Overall there was a substantial reduction in utilization of both acute psychogeriatric admission beds and day hospital placements.

Multi-agency community assessment of elders with mental health problems can be addressed effectively without recourse to hospital admission, which may allow resource release for further service developments.