Systems of Care: Contemporary Clinical Care Models in Geriatric Psychiatry

With the growth of the geriatric psychiatric population increasing and the number of physicians and other professionals to manage geriatric psychiatric illness not keeping pace, it is essential for systems of care to take a creative and expansive approach to solve this problem. This can take many forms and ultimately will require the adoption of a series of convergent initiatives. The psychiatric empowerment of primary care clinicians is an essential element. Psychiatrists can support independent primary care management of mild to moderate psychiatric illness by many supportive approaches. These include the development of standardized, measurement-based algorithms using standardized rating scales and evidence-based psychotropic medication protocols. The empowerment of other allied mental health professionals to manage the psychotherapy and social aspects of mental health care is especially important in geriatric psychiatry. Adoption of modern technological advances, including telemedicine paradigms and app-based decisional support tools, is also critical. Integrated care using the collaborative care model is a popular, efficient, and evidence-based embodiment of many of these principles and serves as an example for other modern approaches to systems of care in geriatric psychiatry. The goal of modern care models is to provide “the right level of care by the right clinician to the right patient for the right illness in the right time and place.” Further developments of modern systems of care will inevitably follow further development and adoption of emerging health care delivery technologies.