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Nursing homes provide long-term care for elderly patients with chronic illness and disability as well as rehabilitation and convalescent care for individuals recovering from acute illness. As documented in previous reviews (Streim and Katz 2009), clinical studies have consistently provided evidence that the diagnosis, management, and treatment of mental disorders are important components of nursing home care. The delivery of mental health services in nursing homes continues to be shaped by several factors, including growing scientific knowledge, availability of new treatments, evolving federal regulations, measurement-based care, the public dissemination of quality measures, and changes in the medical marketplace. In this chapter, we review historical trends and current information on the psychiatric problems common in the nursing home, discuss current trends affecting clinical care, and present a conceptual model for the organization of mental health services in the nursing home setting.
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