Defining best practices for specialty geriatric mental health outreach services: Lessons for implementing mental health reform

Objective: This paper reviews fundamental areas that inform best practices for outreach services as they relate to shared care, education, and program and systems development and illustrates a framework for defining best practices. Method: We examined literature that addresses the needs and characteristics of older persons with mental illness, studies that investigate geriatric mental health outreach services, and relevant theoretical developments. In addition, we synthesized some of the health services field research that we conducted. Results: This analysis provided a foundation for understanding the processes required to identify and implement best practices in specialty geriatric mental health outreach. Constructive insights for a comprehensive approach to the development, implementation, and evaluation of these services emerged. Conclusions: The needs of an aging population, the articulation of principal functions for specialty services within mental health reform, and the realities of individual communities converged to establish direction for service provision. The use of best practices across a range of health and social services, combined with an effective process that facilitates the exchange of knowledge between sectors, establishes an important mechanism by which shared care, education, and program and systems development can be achieved. (Can J Psychiatry 2004:49:458- 466)