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Overview

Mental Health & Older Adults: The Wisconsin Geriatric Psychiatry Initiative (WGPI) & “Star” Method Linda Buel RN May 8, 2009. Overview. The public health crisis Introduction of WGPI & the Star method Early results Outcomes measurement plan Reach. Issues – now and in 2030.

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Overview

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  1. Mental Health & Older Adults:The Wisconsin Geriatric Psychiatry Initiative (WGPI) & “Star” Method Linda Buel RN May 8, 2009

  2. Overview • The public health crisis • Introduction of WGPI & the Star method • Early results • Outcomes measurement plan • Reach

  3. Issues – now and in 2030 • Population aged 65 and older will increase from 20 million in 1970 to 69.4 million • Older adults with mental illness will increase from 4 million in 1970 to 15 million • Ratio of Geropsychiatrists to older adults - 1:11,451 to 1:20,195 Jeste, Alexopoulus, Bartels, et al., 1999 Association of Directors of Geriatric Academic Programs' "Status of Geriatric Workforce Study"

  4. Consequences • compromised quality of life • increased morbidity and mortality- increased service visits, increased burden to medical care providers, and heightened annual costs of care. • premature nursing home placement • preventable hospitalizations Bartels Stephen J, Michael A. Smyer, Mental Disorders of Aging: An Emerging Public Health Crisis?

  5. Wisconsin Geriatric Psychiatry Initiative: Addressing Complexity in the Face of Scarcity Goal: to enhance the delivery of mental health services to older adults in Wisconsin Methods: indirect care via case-based consultative teaching sessions, using the Star Method more widely disseminate principles of geriatric psychiatry to different groups of providers: health care: medical and psychiatric long-term care aging network network weaving: shaping an infrastructure via the strength of weak ties Dr. Tim Howell

  6. Determinants of Health ( Evans and Stoddart, 1990)

  7. Understanding & Addressing Geriatric Problems: The Wisconsin “Star” Method Medication Issues Symptom, Problem Social Issues Medical Issues Personal Issues (Personality) Psychiatric Issues

  8. Early Results - 1 Community Health Partnership report • Patient • Dates of Service • Date of consultation • Activity before • Activity after

  9. Early Results - 2 Community Health Partnership report • Patient Issues • Team Issues • Organization Issues • CT Session results • Changes after consult

  10. Outcomes

  11. Outcomes

  12. Milwaukee: CCO (PACE/Partnership/Family Care), Aurora Geriatrics, & ALM (CBRF) Madison: Care Wisconsin, Family Services Eau Claire: CHP (Partnership/Family Care) AGS website: www.americangeriatrics.org San Antonio & Galveston TX (U Texas), Columbia MO (U Missouri), Rochester MN (Mayo), Baltimore MD (Johns Hopkins), & Milwaukee (MCW): geriatric medicine fellowship programs (by speaker phone from Aurora Geriatrics) Dr. Tim Howell Reach

  13. Acknowledgements • Tim Howell, MD, MA; WGPI Geriatric Psychiatrist Associate Professor, UW Dept of Psychiatry • Cathy Swanson-Hayes - DHS • Other members of the WGPI coalition • University of Wisconsin Hospital & Clinics

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