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Doctors in the house. Home visits for older people: a practical model outside Yorkshire

  • Susan Mary Benbow (a1) and David Jolley (a2)
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Abstract
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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1 Negi, R, Seymour, J, Flemons, C, Impey, M, Thomas, N, Witrylak, R. Psychiatric out-patient clinics for older adults: highly regarded by users and carers, but irreplaceable? Psychiatr Bull 2009; 33: 127–9.
2 Benbow, SM. The community clinic – its advantages and disadvantages. Int J Geriatr Psychiatry 1990; 5: 119–21.
3 Jolley, DJ, Benbow, SM. The everyday work of geriatric psychiatrists. Int J Geriatr Psychiatry 1997; 12: 109–13.
4 Benbow, SM, Jolley, DJ. Gender, isolation, work patterns and stress amongst old age psychiatrists. Int J Geriatr Psychiatry 1999; 14: 719–25.
5 Richardson, B, Orrell, M. Home assessments in old age psychiatry. Advan Psychiatr Treat 2002; 8: 5965.
6 Faculty of Old Age Psychiatry. Raising the Standard. Specialist Services for Older People with Mental Illness. Royal College of Psychiatrists, 2006 (http://www.rcpsych.ac.uk/PDF/RaisingtheStandardOAPwebsite.pdf).
7 Department of Health. Living Well with Dementia: A National Dementia Strategy. Department of Health, 2009.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Doctors in the house. Home visits for older people: a practical model outside Yorkshire

  • Susan Mary Benbow (a1) and David Jolley (a2)
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Doctors in the house. Home visits for older people: a practical model outside Yorkshire

Jeremy Seymour, Old Age Psychiatrist
29 August 2009

28 August 2009

The EditorPsychiatric Bulletin

Dear Sir

We thank Professors Benbow and Jolley for their interest¹ in our paper on older users and carers view on the acceptability of attending Psychiatric Outpatients². They invite us to “set the record straight” in agreeing with them that “in many good services for older people home visits are the reality”. We are pleased to concur with them and refer them to the title of our paper. However, they appear to be confusing “Community Clinics” with community-oriented Mental Health Services.

In her original paper³, Professor Benbow described replacing a Psychiatric Outpatient Clinic with what she designated a “Community Clinic”, whereby the catchment area was divided into four geographical areas, each being visited by the psychiatrist once every four weeks. To our knowledge, this model has not been adopted elsewhere, or if it has, noone has written about it in peer-reviewed journals. Elderly Mental HealthServices in Sheffield are not resourced to provide such a service, or if services were reconfigured in this way, psychiatrist’s time would be deflected from Community Mental Health Team [CMHT] work; or other community-oriented work such as the Dementia Rapid Response Team, and the [functional illness] Discharge and Rehabilitation Team.

Our paper does not in any way suggest replacing community work with outpatients; what we are advocating is efficiently run Outpatient Clinics in the context of well coordinated community-oriented services. Older patients who are independently mobile are capable of attending an Outpatient department, as they do for appointments in general hospitals. For psychiatric patients who are immobile, housebound, refusing to attend,or in residential / nursing homes, in Sheffield they are seen in their ownhome either by a Psychiatrist or another CMHT member.

The purpose of our simple questionnaire study was to assess user/carer acceptability of attending Psychiatric Outpatients. The majority of older users and carers were highly satisfied with all aspects of their attendance, irrespective of the seniority of the psychiatrist seen, and we believe our findings are potentially transferable outside Sheffield.

Professors Benbow and Jolley have made a useful contribution to the literature in logging the activity of old age psychiatrists in different settings. It is equally valid to ask old users and carers of services what they think of this activity.

Yours sincerely

Jeremy Seymour,Rashi Negi,Christopher Flemons,Matthew Impey,Rachael Witrylak andNicola Thomas

¹Benbow SM, Jolley DJ. Doctors in the house. Home visits for older people : a practical model outside Yorkshire. Psychiiatr Bull 2009; 33 : 315.²Negi R, Seymour J, Flemons C, Impey M, Thomas N, Witrylak R. Psychiatric outpatients clinics for older adults : highly regarded by users and carers, but irreplaceable? Psychiatr Bull2009; 33 : 127-29.³Benbow SM. The community clinic – its advantages and disadvantages. IntJ Geriatr Psychiatry 1990; 5 : 119-21.
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