Multidisciplinary perspectives on geriatric mental health service delivery: a mixed-method survey study in a large integrated healthcare system

To guide training development efforts within the context of the geriatric mental health (MH) workforce shortage, we examined provider perspectives on serving older adults in the Veterans Health Administration (VA), the largest integrated health care system in the U.S. For this mixed-method observational study, 489 multidisciplinary VA MH clinicians across five sites responded to an e-mail invitation to complete a survey assessing confidence in serving older adults with and without cognitive disorders, perceived barriers to providing services, and importance of training in geriatric MH. Text comments from a subset of participants (N = 59) were analyzed using thematic consensual qualitative analysis. Quantitative results indicate that most respondents (n = 418, 92.3%) endorsed the importance of having skills for serving older adults but reported modest self-efficacy, especially for delivering treatments and for serving patients with cognitive disorders. Barriers related to clinic systems were most frequently endorsed. Perceived need for training was high, with few differences by provider or setting characteristics. Qualitative data integration provided convergent evidence for the main findings. Our study contributes to the growing literature on providing MH services for older adults, including those with dementia, and can inform efforts to address the geriatric workforce shortage.