Building Resilience: A Specialty Clinic Tailored to Older Adults at Risk for Violence and Abuse

Authors

Melba A Hernandez-Tejada
Deborah M Little
Madeline J Bruce
Sarly Butte
Jason Burnett
Leila Wood
Ron Acierno

Publication Date

11-1-2024

Journal

International Journal of Psychiatry Medicine

Abstract

Objective: Both structural (e.g., ageism) and personal (e.g., stigma) barriers hinder older adults' access to and engagement with mental health care. These barriers are particularly problematic for those vulnerable to interpersonal violence and abuse (e.g., due to social isolation). This study presents a quality improvement program aimed at older adults who have experienced significant stressful events, particularly elder mistreatment, within a larger trauma specialty clinic. Leveraging home-based telemedicine, the clinic provides evidence-based psychotherapy tailored to the needs of older adults.

Methods: From 2021 through 2023, the authors retrospectively examined treatment initiation, engagement, completion, and clinical outcomes among 231 older adults age 60+ who reported trauma that met DSM-5 criterion A criteria for post-traumatic stress disorder, depression, or other mental health comorbid conditions related to their traumatic event. The clinic uses an automated measurement-based care approach that facilitates Quality Improvement projects, allowing the tracking of treatment initiation, engagement, completion, and clinical outcomes for all patients.

Results: The results indicated high treatment completion, high engagement with telemedicine-delivered interventions, and, most importantly, significant changes in clinical outcomes.

Conclusion: These findings highlight the importance of expanding telemedicine-based mental health services for older adults, challenging ageist norms, and prioritizing older adults' mental health needs by providing tailored services to this patient population.

Keywords

Humans, Aged, Female, Male, Elder Abuse, Resilience, Psychological, Middle Aged, Telemedicine, Retrospective Studies, Aged, 80 and over, Stress Disorders, Post-Traumatic, Quality Improvement, Psychotherapy, Mental Health Services, Violence, older adults, ageism, elder mistreatment, PTSD, depression, clinical outcomes, treatment engagement

DOI

10.1177/00912174241272591

PMID

39097799

PMCID

PMC1149256

PubMedCentral® Posted Date

8-4-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes