Objective: To determine the effectiveness of a nurse-led mental health liaison service in managing mental health problems in older physically ill in patients.
Design: Randomized Controlled Trial
Materials and Methods: Participants were 153 older people (aged 65 or over) admitted to a medical ward of an English district general hospital, who scored above the threshold for depression and/or cognitive impairment on a brief screening instrument (4-item geriatric depression scale and 6-item orientation-memory-concentration test): 77 were randomized to receive an intervention and 76 to usual care. 120 participants completed 6-8 week follow up assessments and were included in the analysis.
The intervention was a nurse-led mental health liaison service and the main outcome measures the geriatric depression scale and the standardized Mini-Mental State Examination (MMSE).
Results: Participants randomized to the intervention group (nurse-led care) had significantly lower geriatric depression scale scores at 6-8 week follow up than those in the usual care group(12.2 v. 14.0, adjusted mean difference -2.0, 95% confidence interval -4.0 to -0.1, p=0.043). There were no significant differences on the MMSE test scores.
Conclusion: A nurse-led mental health liaison service may be an effective intervention for older medical inpatients with mental health problems, particularly depression.
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