Monday, 18 August 2003
This presentation is part of : Monday Poster Sessions

PA-008 Improving Geriatric Mental Health Care through the Internet: Challenges and Strategies

Karen Lynn Cheal, Sue Ellen Levkoff, and Reem Tabbarah. Psychiatry, Brigham and Women's Hospital, Boston, MA, USA

Objective:This research aims to understand and propose strategies to surmount some of the challenges in using the Internet to improve geriatric mental health care and increase knowledge of mental health conditions among older adults, and their families, caregivers, and health care providers. Design:The study consists of a series of focus groups with older adults and providers in the Boston, MA area to assess barriers to accessing and benefiting from mental health information on the Internet and to explore different strategies to overcome these barriers. IRB approval was granted to gain access to older adults in the Cambridge Senior Center, who represent a diversity of racial and ethnic backgrounds and ages. Participating health care providers include psychiatrists, psychologists, social workers, and primary care physicians from the Harvard Medical area. Materials and Methods:Focus groups of approximately 10 participants were facilitated by a licensed clinical social worker and a web designer. Discussions with older adults focused on three topics: stigma, cultural competence, and accessible Internet technology. Discussions with providers requested input on useful resources and site endorsement; and providers additionally filled out a questionnaire on desired web functions and tools. Participants’ use of the Internet and barriers to its use were also discussed. To assess factors affecting site usability, web page layouts were presented and discussed. Data were compiled and analyzed for common themes. Results:Providers expressed time as their biggest barrier to accessing work-related content on the Internet. E-mails, with embedded site links, would be useful to alert providers to site updates. Brief summaries of evidence-based practice from peer-reviewed journals would help keep providers current. Screening tools and recognizable signs of mental health conditions would be useful in identifying new cases, particularly for providers without extensive training in mental health. Psychiatrists and psychologists expressed the importance of the website having affiliations with reputable institutions and organizations. A common theme among older participants was lack of access to the Internet (lack of computer or inadequate skills), but most would be receptive to gaining Internet skills or having a family member access content for them, especially if it were recommended by their provider. Some did feel comfortable using the Internet and were aware of public computer resources. The Internet would provide a less stigmatized means for older adults to learn more about mental health. Vignettes, incorporating different cultures, would resonate better than medical information alone. Other useful content would include easy-to-read insurance and prescription drug coverage information and tips on staying healthy. Conclusion:The Internet is a viable medium for increasing awareness and knowledge of mental health and the elderly, provided its content is tailored to each target audience. Older adults receive care from a myriad of health care providers, each requiring different resources. Although elders are receptive to using the Internet, outreach must include family members and caregivers, who might be more likely to access the Internet.

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