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

OBJECTIVES: To identify the experience and perceptions of multidisciplinary nursing facility leaders regarding need for psychiatric services in residents of long-term care.
DESIGN: Cross-sectional study.
SETTING: Nursing facilities in Hawaii. PARTICIPANTS: 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). MEASUREMENTS: Educational experience, psychiatric service perceptions, and needs as assessed by survey questions.
RESULTS: 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.
CONCLUSION: 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.