Community treatment of older adults: principles and evidence supporting mental health service interventions

Health care systems are evolving toward population-based approaches to managing disease, including mental and behavioral health problems. This article describes population-based care management for treatment of geriatric patients in primary care and the challenges of implementation. The article addresses the issues of program fidelity and real-world treatment of those who do not fit the model or do not respond as hoped. It also discusses the special obstacles facing efforts to apply population-based principles of mental health care in nursing homes, where regulatory requirements, more than evidence about effective treatment, drive what interventions are provided.