Defining the Role of the Fire and Rescue Service in Mental Health Support for Older Adults: A Qualitative Study

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Expectations Pub Date : 2024-09-19 DOI:10.1111/hex.70028

Tamsin Fisher, Carolyn A. Chew-Graham, Nadia Corp, Saeed Farooq, Paul Kingston, Ian Read, Gary Spolander, Jane Southam, Dean Stevens, Carmel Warren, Tom Kingstone

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Abstract

Introduction

Anxiety and depression in older adults (60+ years of age) are under-diagnosed and under-treated. Older adults are less likely to seek help for these problems due to a lack of awareness, difficulty accessing health care due to availability or disability and fear of loss of independence. Existing points of contact between older adults and non-traditional services, for example, the Fire and Rescue Service (FRS), could provide opportunities to support help-seeking for mental ill-health. The FRS conduct Home Fire Safety Visits (HFSVs) with older adults and are well positioned to provide health-related support. This study examines a range of perspectives on the potential role of the FRS in the identification of, and signposting for, anxiety and depression in older adults.

Methods

This was a qualitative study carried out using mixed methods in West Midlands, UK. Semi-structured interviews were conducted with older adults and health and social care providers (practitioners, managers, commissioners) to explore the acceptability of the FRS expanding its role to detect and signpost for anxiety and depression in older adults. Observations examined delivery of existing HFSVs to older adults. Data were combined and analysed using a reflexive thematic approach.

Results

Eighteen health and social care providers and 8 older adults were interviewed; 10 HFSVs were observed. Two overarching themes were identified: (1) Potential role for the FRS and (2) Operationalising identification of mental health problems by FRS. Interviews and observations demonstrated how HFSVs offer a suitable opportunity to start conversations about mental health. All interview participants felt that although the FRS would be well placed to deliver an intervention, they would require training, support and a referral pathway co-produced with and supported by health and social care partners.

Conclusion

A whole-system approach is needed if the FRS are to expand HFSVs to identify mental health problems in older adults and provide signposting to appropriate services.

Patient or Public Contribution

J.S. is a public co-investigator. A Patient Advisory Group contributed to the initial funding application, design and conduct of the study, including data analysis and advice on dissemination.

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界定消防和救援服务在为老年人提供心理健康支持方面的作用：定性研究

导言：老年人（60 岁以上）的焦虑症和抑郁症诊断和治疗不足。由于缺乏相关意识、因身体状况或残疾而难以获得医疗服务以及害怕失去独立性，老年人不太可能就这些问题寻求帮助。老年人与非传统服务机构之间的现有联系点，例如消防和救援服务机构（FRS），可以为老年人寻求精神疾病方面的帮助提供机会。消防和救援服务局对老年人进行家庭消防安全访问（HFSVs），完全有能力提供与健康相关的支持。本研究探讨了联邦消防局在识别和引导老年人焦虑和抑郁方面的潜在作用。方法这是一项在英国西米德兰兹郡（West Midlands）采用混合方法开展的定性研究。研究人员对老年人以及医疗和社会医疗服务提供者（从业人员、管理人员、专员）进行了半结构式访谈，以探讨是否可以接受将 FRS 的作用扩大到检测老年人的焦虑症和抑郁症并发出治疗信号。通过观察，对现有的针对老年人的家庭健康和社会医疗服务进行了评估。采用反思性主题方法对数据进行合并和分析。结果对 18 名医疗和社会护理服务提供者以及 8 名老年人进行了访谈，并观察了 10 次 "家庭健康支持服务"。确定了两个重要主题：(1) 家庭护理服务的潜在作用；(2) 家庭护理服务对心理健康问题识别的可操作性。访谈和观察表明，家庭健康状况调查小组为开始有关心理健康的对话提供了一个合适的机会。所有的访谈参与者都认为，虽然家庭健康服务机构可以很好地提供干预措施，但是他们需要培训、支持以及与医疗和社会医疗合作伙伴共同制定并得到他们支持的转介途径。结论如果要扩大家庭健康状况调查的范围，以识别老年人的心理健康问题，并为其提供适当的服务，就需要一个全系统的方法。患者或公众贡献 J.S. 是一名公众共同研究员。患者咨询小组为最初的资金申请、研究的设计和实施做出了贡献，包括数据分析和传播建议。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.