Finding a good mental health provider can be challenging even when transportation and mobility are not an issue. For people who live in an assisted living facility and don't have the ability to hop in a car and drive to a psychiatrist's office, things get a lot more challenging.
When it comes to the mental health needs of residents of assisted living facilities, clearly there is a great deal of unmet need. In an enlightening 2003 study, administrators of 94 assisted living facilities in Michigan completed a 19 item survey about the extent of mental health problems of residents and how such problems were addressed. Not surprisingly, the three most commonly reported mental health problems were dementia, depression, and hallucinations or delusions, while the three most commonly reported problematic behaviors were resistance to care, wandering, and verbal abuse.
Barriers that prevent a resident from receiving mental health care include resident refusal, family refusal, cost, and stigma of mental illness. Stigma is particularly problematic in older adults. With depression, for example, when older adults seek mental health treatment they are challenging the incorrect and discriminatory idea that depressive symptoms are a normal part of aging.
Sometimes the facility itself contracts with a mental health provider such as a geriatric psychiatrist to see facility residents who have a need. Requesting a referral from the resident's primary care physician is another means of accessing a mental health provider. Often the facility administrator or nursing director know who the mental health providers in the community are, and the Alzheimer's Association may be helpful as well. Other medical professionals with expertise in Alzheimer's disease may be accessible, and the Geriatric Mental Health Foundation has a "find a geriatric psychiatrist" referral service.
Wagenaar D, D.O.,M.S., Mickus M, Ph.D. et al., "An Administrator's Perspective on Mental Health in Assisted Living",Psychiatric Services 54:1644-1646, December 2003.