Behavioral Health Services with Short-Stay Residents in Skilled Nursing Facilities: A Qualitative Study of Clinicians and Administrators

ABSTRACT

Objectives

The perspectives of professionals involved in behavioral health (BH) services with short-stay residents in skilled nursing facilities (SNFs) are rarely captured in the literature. This study examines the real-world experiences of BH clinicians and administrators in post-acute/subacute care units in SNFs.

Methods

This qualitative study used semi-structured interviews with 18 clinicians (e.g., psychologists and social workers) and five administrators (e.g., directors of social services or BH company executives) involved in BH services with short-stay SNF residents. Interviews were recorded, transcribed, and analyzed by two independent coders using conventional thematic content analysis.

Results

Three themes emerged from the data: (1) BH needs are high among short-stay residents and families during post-acute care transitions; (2) BH services offer multiple unique opportunities to enhance post-acute/subacute care in SNFs; and (3) barriers to providing optimal BH care exist at multiple levels and require action from BH clinicians and stakeholders.

Conclusions

Variability in clinician roles and barriers to optimized care suggest the need for future research targeting best practices and implementation strategies for BH services with short-stay SNF residents.

Clinical Implications

Results identified multiple ways in which BH services may enhance resident, family, and staff outcomes, as well as the milieu in SNFs.

KEYWORDS:

• Skilled nursing facility
• post-acute care
• mental health
• behavioral health
• qualitative

Clinical implications

• In addition to contributing to rehabilitation care plans, BH may enhance post-acute/subacute SNF care through advocacy and staff education and support.

• Post-acute/subacute units in SNFs may be an important point of contact for assessment, psychoeducation, and treatment planning for BH concerns among older adults and their family.

• Family care partners may benefit from BH services during short-term SNF stays; yet, future research is needed to address clinician, facility, and system barriers with this patient population.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementry material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by a training grant from the National Institute on Aging [Grant No. T32AG044296].