Behavioral Health Services Missing In U.S. Nursing Homes

Researchers at the University of Rochester School of Medicine started surveying randomly selected skilled nursing facilities in 2017, asking questions about the types of behavioral health issues residents have, available behavioral health services, quality, satisfaction, staffing, staff education, turnover and service barriers. Now complete, the results of the study were published in the Journal of the American Geriatrics Society on June 5, 2019 and show that mental health disorders can affect up to 90 percent of nursing home residents in as many as a third of the nation’s nursing homes and community-based care facilities.

In this first review of its kind, researchers measured four different outcomes:

1. Adequacy of behavioral health staff education
2. Ability to meet resident behavioral health service needs
3. Adequacy of coordination/collaboration between nursing home/community providers
4. Availability of necessary facility infrastructure

“Inadequate behavioral health education and psychiatric training among nursing home staff were associated with subpar provision of behavioral services in this care setting,” the researchers reported. “New initiatives that increase access to behavioral health providers and services and improve staff education are urgently needed.”

The study authors also noted that behavioral health staff education was less of an issue in nursing homes with Alzheimer’s and dementia units, where staff turnover tends to be lower, and more psychiatrically trained RNs and social workers are present. In all though, access to care for those with special cognitive conditions is generally considered concerningly inadequate and Medicaid reimbursement rates are generally low to help pay for these services.