Objective: By 2021, people 65 years of age and older will account for 18 percent of the Canadian population, or approximately 6.7 million people. The majority of these individuals will continue to reside in the community setting. For those requiring treatment for mental health and/or addiction problems, the literature with respect to effective models of community care remains equivocal. The authors of this paper review the evolution and future directions of a community psychogeriatric service within one of Canada's largest mental health and addictions facilities.
Design: This paper undertakes a retrospective review of accomplishments and challenges in delivering treatment and care within the context of a long-standing ambulatory psychogeriatric service, known as the "PACE" Clinics (Psychogeriatric Assessment Consultation and Education), in Toronto, Canada. Four core variables in the development of effective community service will be examined: clinical functions; service components; human and financial resources; and, structures required to link all functions and components together in a collaborative fashion.
Materials and Methods: Review of service planning documents, models, and client/utilization data over time.
Results: In order to assure future viability, the PACE Clinics have had to embark on a process of renewal and reform. Clinical functions such as intake, screening and consultation are being restructured in response to client needs, limited human/financial resources, and influence from other community stakeholders.
Conclusion: There remains a lot of work to be done in terms of further development of effective community care models appropriate for addressing the needs of seniors with mental health and/or addiction problems. The successes and challenges of one community psychogeriatric program may be particularly instructive to those embarking on developing such services. Future trends and opportunities are also highlighted.
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