A comparison of methods for the evaluation of mental health day hospitals for older people

Abstract

In many countries, day hospitals have become a cornerstone of psychiatric care for the elderly. However, there have been few studies of their working processes and effectiveness. In this study two standardised assessment tools (the World Health Organisation guidelines and the Health Advisory Service 2000 standards and criteria) and a number of process measures of clinical activity, were compared during an evaluation of 10 day hospitals in the UK. The WHO guidelines provided the most detailed assessment but included items, which were less appropriate in the UK. Common problems identified in the day hospitals were the lack of an appropriate range of clinical disciplines, unsuitable physical environments and inappropriate referrals because of the lack of alternative social day care. Seven day hospitals met the HAS 2000 standard and all of these scored over 110 on the WHO checklist. The three day hospitals not meeting the HAS 2000 standard all scored below 110 and a key reason for this was that they had a tendency to focus on social care. The assessment tools were easy to use and provided useful information about day hospital effectiveness.