A Comprehensive Geriatric Psychiatry Program in Canada

A single patient receiving comprehensive psychiatric care from Baycrest Centre may be identified in the community, may be offered services at home, may receive family intervention, or may be admitted to a more intensive level of acute care without being moved from one psychiatric program to another. Medical, social, and home support services may be built into the patient's overall treatment program because the center maintains formal links with established community resources.

Because of its commitment to geriatric care, the comprehensive extended care setting is an appropriate location for comprehensive psychiatnc services for geriatric patients. Long-term-care settings such as nursing homes offer unique opportunities for teaching and learning the special treatment and consultation-liaison skills necessary to provide care to elderly persons with chronic mental illness. At Baycrest Centre, integration of various clinical activities has been possible because the Canadian universal health care plan permits psychiatrists to provide direct care for elderly patients regardless of their setting with no financial penalty. Despite this advantage, however, the program has to find and coordinate multiple levels of funding and support to meet the needs of the population it serves.

The planning of mental health services for elderly persons is influenced by extraneous factors including political priorities, community pressure, and the availability of funds or resources, as well as academic considerations in university-centered programs. However, rational service development more properly is based on the problems, needs, and demands of elderly persons and their families. Successful planners should begin by considering who will use the services and what resources already exist, but they must also be able to integrate various sources of funds and elicit political support at all levels.