Trends in Mental Health Admissions to Nursing Homes, 1999–2005

Abstract

Objectives-To measure trends and characteristics of first-time nursing home admissions for individuals with mental illness, dementia or both from 1999-2005.Methods-The Minimum Data Set was used to estimate the number and percent of elderly residents newly admitted to nursing homes who had mental illness (schizophrenia, bipolar disorder, depression or anxiety), dementia, or both from 1999-2005.In 2005, demographic factors, comorbidities, and treatments by mental illness status were compared.Results-The number of individuals admitted with mental illness increased from 168,721 in 1999 to 187,478 in 2005 and currently exceeds by 50% the number admitted with dementia only (118,290 in 2005).This increase in mental illness is driven by depression, which increased from 128,566 to 154,262.Residents admitted with depression exhibited higher rates of comorbidities, high rates of antidepressant treatment, and high rates of receiving training in skills required to return to the community.Conclusions-Over the past decade, the number of nursing home admissions for mental illness, in particular depression, has overtaken the number for dementia.These changes may be related to increased recognition of depression, changes in the availability of nursing home substitutes for residents with dementia, and the increased specialization of nursing homes in the care of post-acute, rehabilitation residents.In recognition of these changes, improving the resources of nursing homes to adequately treat residents with mental illness is critical to help facilitate reintegration into the community.