Psychiatric services: experience, perceptions, and needs of nursing facility multidisciplinary leaders

To identify the experience and perceptions of multidisciplinary nursing facility leaders regarding need for psychiatric services in residents of long-term care.

Cross-sectional study.

Nursing facilities in Hawaii.

Surveys were sent to 188 nursing facility administrators, medical directors, directors of nursing, and directors of social work at 47 facilities in Hawaii; 99 individual staff responses (52% response rate) were received from 42 facilities (89% response rate).

Educational experience, psychiatric service perceptions, and needs as assessed by survey questions.

The most commonly cited reasons for not accepting a patient with a recent history of or current psychiatric or behavioral problems were concerns of dangerousness (73.5%), the need for greater staff attention (64.3%), and difficulty accessing psychiatric support and follow-up after admission (53.1%). Easy accessibility (66.3%) was the most essential consultant quality, and pharmacological treatment interventions (88.4%) were deemed most helpful. Behavioral management of dementia (93.6%) was the most requested educational topic, followed by depression and suicide (77.7%). There were some differences noted between specialties.

The findings highlight the unmet needs of nursing facility leaders, gives direction to and reinforces how psychiatrists, by virtue of their training and skills, can play a central role in meeting these needs, and offer a glimpse of the potential for collaboration to addresses the mental health and psychiatric service needs of the long-term care residents.