International Psychogeriatrics

Focus on mental health issues in long-term-care homes

Screening for mental disorders in residential aged care facilities

Nancy A. Pachanaa1 c1, Edward Helmesa2, Gerard J. A. Byrnea3a4, Barry A. Edelsteina5, Candace A. Konnerta6 and Anne Margriet Pota7a8

a1 School of Psychology, University of Queensland, Brisbane, Australia

a2 School of Psychology, James Cook University, Townsville, Australia

a3 Discipline of Psychiatry, School of Medicine, University of Queensland, Brisbane, Australia

a4 Geriatric Psychiatry Service, Royal Brisbane and Women's Hospital, Brisbane, Australia

a5 Department of Psychology, West Virginia University, Morgantown, West Virginia, U.S.A.

a6 Department of Psychology, University of Calgary, Calgary, Canada

a7 Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

a8 Department of Clinical Psychology, VU University, Amsterdam, The Netherlands


Introduction: The International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care Facilities seeks to improve care of persons in residential aged care facilities (RACFs). As part of that effort the current authors have contributed an overview and discussion of the uses of brief screening instruments in RACFs.

Methods: While no current guidelines on the use of screening instruments in nursing homes were found, relevant extant guidelines were consulted. The literature on measurement development, testing standards, psychometric considerations and the nursing home environment were consulted.

Results: Cognitive, psychiatric, behavioral, functional and omnibus screening instruments are described at a category level, along with specifics about their use in a RACF environment. Issues surrounding the selection, administration, interpretation and uses of screening instruments in RACFs are discussed. Issues of international interest (such as translation of measures) or clinical concern (e.g. impact of severe cognitive decline on assessment) are addressed. Practical points surrounding who can administer, score and interpret such screens, as well as their psychometric and clinical strengths more broadly, are articulated.

Conclusions: Guidelines for use of screening instruments in the RACF environment are offered, together with broad recommendations concerning the appropriate use of brief screening instruments in RACFs. Directions for future research and policy directions are outlined, with particular reference to the international context.

(Received November 30 2009)

(Revised December 15 2009)

(Revised January 04 2010)

(Accepted January 12 2010)

(Online publication April 06 2010)


c1 Correspondence should be addressed to: Nancy A Pachana, School of Psychology, University of Queensland, Brisbane, Australia. Phone: +617-3365-6832; Fax +617-3365-4466. Email: