All sides agree: residents need better mental healthcare.

Industry stakeholders from a wide variety of disciplines have put aside differences and agreed on the need for better mental healthcare in nursing homes. An interdisciplinary panel, led by the American Geriatrics Society (AGS) and the American Association for Geriatric Psychiatry (AAGP), issued a consensus statement calling for:

* Routine screening for depression in all nursing home residents

* Improved screening instruments

* First-line treatment of major depression with antidepressant medications in combination with nonpharmacologic interventions

* Improved environments for residents to enhance their independence, wellbeing, and quality of life

* Better assessment tools for residents with dementia-related behavioral symptoms

* Regular evaluation to determine if a resident's symptoms may be the result of adverse drug interactions or other medical conditions

* Reassessment of barriers to using effective drug therapies, such as restrictive formularies and attitudes about using psychotropic drugs as "chemical restraints"

To implement the panel's clinical recommendations, AGS and AAGP issued several policy recommendations:

* Make mental health services more available to nursing homes, particularly those in rural areas and those that are publicly financed.

* Include coverage for mental health services and medications in public and private insurance plans that cover nursing home residents.

* Reward facilities that provide appropriate pharmacologic and nonpharmacologic treatment for residents with mental illness.

* Encourage staff training to identify residents with mental illness.

* Promote research to identify the best practices in meeting the mental healthcare needs of nursing home residents.

In addition to AGS and AAGP members, the panel included representatives from the National Association of Directors of Nursing Administration in Long Term Care (NADONA), National Citizens' Coalition for Nursing Home Reform (NCCNHR), American College of Health Care Administrators (ACHCA), American Association of Homes and Services for the Aging (AAHSA), American Health Care Association (AHCA), American Medical Directors Association (AMDA), and others. Unrestricted grants from Eli Lilly and Company and Janssen Pharmaceutica supported the project.

For more information, see the September 2003 issue of the Journal of the American Geriatrics Society.