Professional Care for the Elderly Mentally Ill, 1

Services to older people with mental health problems have gone through radical change in recent years. Legislation has had a profound effect by dictating how care to older people is delivered both within hospital and within the community. The recent government agenda emphasizes cost effectiveness, value for money and accountability. This, too, is an important driving force in re-evaluat ing the service, although not everyone would agree with many of the proposed strategies and there are clearly different views as to the appropriateness of many of the services. One thing is certain, however - the move towards interdiscipli nary working is here to stay. Not all change has been led by legislation, and many innovations have been founded in the day-to-day practices in the care of older people with mental health problems. A service, of course, does not become integrated merely by imposing joint working on a number of professionally based disciplines, and in many ways this may not be desirable. At its worst it produces duplication, where people from different background are all doing the same job. This is not the intention of joint-working, instead it should attempt to improve the quality of service by a rich mix of skills and experience from a number of related disciplines.