Abstract
Background. Long-term care facilities are experiencing rapid increases in the number of residents with serious persistent mental illnesses (SPMI) and substance use disorders (SUD).
Aims. The purpose of this paper is to propose a new model for long-term care, the Collaborative Care Model, to bring expert mental health care to these residents more effectively.
Methods. Two composite case studies of long-term care residents, one with serious persistent mental illnesses, the other with substance use disorder, are presented. One represents the traditional model of expert external consultation, the other represents the use of the Collaborative Care Model. The cases are analyzed in terms of the similarities and differences in the problem presented and the approach used, as well as interpretation of the outcomes of these long-term care stays.
Results. The most striking differences between the two approaches to obtaining external expert guidance were 1) the multifaceted nature of the Collaborative Care Model, which included staff education, consultation with the facility pharmacist, discussions with both the resident and family members, and meetings with the staff and management of the facility, and 2) improved outcomes for the residents
Conclusions. The Collaborative Care Model promises to offer a more person-oriented, interdisciplinary approach to obtaining expert mental health care for a resident in need of it. The model should be subjected to rigorous testing to evaluate the effect of its use on long-term care resident outcomes.