Exploring the Landscape of Intensive Outreach Services for Older Adults With Serious Mental Illness: A Scoping Review

Older adults living with mental illness, particularly those with serious mental illness (SMI), represent a vulnerable and underserved patient population. Deinstitutionalization laid the groundwork for intensive outreach services for this population, yet little attention was paid to the unique needs of older individuals with SMI. We conducted a scoping literature review to map the landscape of intensive outreach services developed for older adults living with SMI. We specifically focused on peer-reviewed literature. EMBASE, MEDLINE, PsycINFO and CINAHL databases were searched for pertinent literature between 1990 and 2023. Fourteen studies were selected for inclusion from 2,952 articles screened. Most studies were descriptive (N = 7). There were three randomized controlled trials (N = 3), three quasi-experimental studies (N = 3) and one (N = 1) pre-experimental study. All programs had a multidisciplinary component with a wide range of allied health clinicians. Six programs were adapted from the assertive community treatment model. Three programs included medical specialists. Only seven studies focused on examining treatment outcomes or efficacy, though there was notable variability in outcome measures analyzed. While intensive outreach services for older adults with SMI show promise, this scoping review highlights the paucity of research in this area. Future research rigorously evaluating models of care, with emphasis on fidelity, cost-effectiveness and patient outcomes, will be essential to inform service delivery to this population.