Formal and informal support for older adults with severe mental illness

Objectives: This study sought to examine the combination of formal and informal services supplied to older adults with severe mental illness, to assess the adequacy of services received, and to determine factors predictive of formal and informal service provision. Methods: A cross-sectional research design was employed. Seventy-five older adults diagnosed with a SMI were recruited through local community mental health center. Data was collected through face-to-face interviews using the Camberwell Assessment of Needs for the Elderly. Results: Clients most frequently received services from formal sources for psychiatric distress, physical health, information, and dangerous behavior needs while informal sources provided the greatest amount of assistance for self-care, psychiatric distress, and money management needs. Appropriate assistance was most often not provided for benefits, sight/hearing, and incontinence. Formal services were predicted by group residence and dangerous behavior, physical illness, medication, and daily activity needs. Assistance from informal sources was predicted by private residence, self-care, mobility, and money management needs. Discussion: While formal and informal sources provided adequate services for certain client needs, over 70% of the clients did not receive the correct type of help for some of their needs. Greater communication between mental health care staff and informal caregivers, and the integration of aging network services, is essential for the adequate provision of care to older severely mentally ill (SMI) adults. Education and greater linkages among care providers are necessary so that all service providers are aware of and are able to appropriately respond to the complex multi-level needs experienced by older SMI adults.