Divergence and integration of identification methods for geriatric mental health disorders in nonspecialized institutions—a qualitative study of service providers from different departments in Shanghai, China

Abstract

Objectives

Global epidemiological evidence indicates high rates of mental illness but low rates of diagnosis among older people. In China, service providers identify older adults with mental disorders in varied ways. Taking Shanghai as an example, this study revealed how the identification methods of geriatric mental health disorders in nonspecialized institutions diverge, providing a reference for the integration of services.

Methods

A purposive sampling method was adopted to conduct semi-structured interviews with 24 service providers from various nonspecialized geriatric mental health care institutions. Interview audio was recorded with consent and converted into verbatim transcripts. The interview data were analysed thematically.

Results

Although service providers from the health care system tended to apply a biomedical-oriented assessment, those from the social care system typically identified mental disorders among older people based on selective attention and interpersonal relationships. Although there are stark differences, the various identification mechanisms implicitly converge—the relationship with clients has become an important consideration.

Conclusion

Geriatric mental health issues urgently require the integration of formal and informal care resources. Referring to the idea of task transfer, social identification mechanisms are expected to be a useful supplement to traditional biomedical-oriented identification.

Keywords:

• Mental health
• social identification
• integrated care
• service system
• service providers

Disclosure statement

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

Ethical standards

This study was approved by Fudan University IRB committee (No. FE21142).

Additional information

Funding

The study is jointly supported by the Partnership in Implementation Science for Geriatric Mental Health (PRISM), from the NIH - National Institute of Mental Health, USA (Award No. U19MH113201), and the China Social Academy Research Fund (Grant no. 21BSH130).