Understanding working-age adults with mental illness living in nursing homes

了解居住在疗养院的患有精神疾病的工作年龄成年人

• 批准号: 9762208
• 负责人: Kate L Lapane
• 金额: $ 20.94万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-13 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762208
• 关键词: Address; Adult; Age; Age-Years; Amendment; American; Americans with Disabilities Act; Anxiety Disorders; Area; Caring; Certification; Characteristics; Clinical assessments; Communities; Data; Data Collection; Data Set; Diagnosis; Discipline of Nursing; Discrimination; Effectiveness; Ensure; Foundations; Health; Health Services Needs; Health care facility; Home Nursing Care; Home environment; Impaired cognition; Individual; Institutionalization; Knowledge; Length of Stay; Link; Long-Term Care; Longitudinal observational study; Medicaid; Medicare/Medicaid; Mental Depression; Mental Health Services; Mental disorders; Modeling; National Institute of Mental Health; Nursing Homes; Nursing Services; Ownership; Patients; Population; Post-Traumatic Stress Disorders; Prevalence; Process; Provider; Psychiatric Hospitals; Psychiatric therapeutic procedure; Psychotic Disorders; Quality of Care; Quality of life; Questionnaires; Reporting; Research; Resort; Schizophrenia; Services; Source; Subgroup; Supreme Court Decisions; Surveys; System; United States Dept. of Health and Human Services; Vulnerable Populations; Work; aged; clinical care; community based care; community based service; experience; falls; improved; instrument; medical specialties; neglect; prevent; programs; screening; severe mental illness; young adult

PROJECT SUMMARY/ABSTRACT The 1990 Americans with Disabilities Act (ADA), 1999 Olmstead Supreme Court Decision, and ADA Amendments Act of 2008 are supposed to protect people with serious mental illness (SMI) against discrimination by considering institutionalization as the last resort to be used only if integrated community-based services are not a viable alternative. Despite these federal mandates, nursing homes may have replaced state psychiatric hospitals as the default source of care. Nursing homes now serve more adults with mental illnesses than all other healthcare facilities combined. Between 10-25% of nursing home residents are thought to have SMI. Residents with SMI are often younger than the typical resident and require services that nursing homes might not be able to provide. Knowledge is lacking about the current extent of this potential warehousing of working-age adults with SMI. We propose using data from the 2011-2016 federally mandated, longitudinal Minimum Data Set 3.0 and Certification and Survey Provider Enhanced Reporting files to conduct an observational longitudinal observational study of adults between the ages of 22 and 64 years with SMI residing in nursing homes. Our specific aims are to: 1) estimate the overall prevalence of SMI among these working-age nursing home residents and to describe the length of stay by psychiatric disorder; 2) examine receipt of psychiatric treatment for these residents; and 3) use latent variable models to identify distinct subgroups of functioning among those with SMI and describe relationships between these subgroups, resident and facility characteristics, and disposition status. This proposal addresses the National Institute of Mental Health’s Strategic Objectives 2: to chart mental illness trajectories to determine when, where, and how to intervene and 4.1: to improve the efficiency and effectiveness of existing mental health services through research. This exploratory research will inform efforts to improve the delivery of mental health services to a particularly vulnerable population by illuminating the current care needs of working-age adults with mental illness.

项目摘要/摘要 1990年《美国残疾人法》（ADA），1999年奥尔姆斯特德最高法院的裁决和ADA 预计2008年的修正案将保护患有严重精神疾病的人（SMI）免受歧视 通过将制度化视为仅在基于社区的综合服务的情况下才能使用的最后一个度假胜地 不是可行的替代方案。尽管有这些联邦任务，但护士房屋可能已取代了州精神病学 医院是护理的默认来源。现在，疗养院服务于精神疾病的成年人比其他所有其他人服务 医疗机构总和。认为10-25％的护士家庭居民被认为具有SMI。居民 与SMI相比，SMI通常比典型的居民年轻，需要护士房屋可能无法的服务 提供。知识缺乏对这个潜在的工作年龄成年人的当前范围的知识 与smi。我们建议使用2011 - 2016年联邦强制性的纵向最小数据集的数据3.0 以及认证和调查提供商增强报告文件以进行观察纵向 SMI居住在护士家庭中的22至64岁年龄段的成年人的观察性研究。我们的 具体目的是：1）估计这些工人护士居民中SMI的总体流行 并描述精神障碍的住院时间； 2）检查这些的精神治疗 居民； 3）使用潜在变量模型来识别具有SMI患者的不同功能子组 并描述这些亚组，居民和设施特征与处置状态之间的关系。 该建议涉及美国国立心理健康研究所的战略目标2：绘制精神疾病 轨迹以确定何时，何地和如何干预和4.1：提高效率和有效性 通过研究的现有心理健康服务。这项探索性研究将为改善 通过阐明当前的护理需求，向特别脆弱的人群提供心理健康服务 患有精神疾病的工作年龄成年人。