Serious Mental Illness, Substance Use Disorder, and Nursing Home Care: A Narrative Review of the Literature.

The prevalence of serious mental illness (SMI) and substance use disorders (SUD) among residents in skilled nursing homes is increasing yet staff are generally not equipped to care for these residents. There is a pressing need to identify and assess practices, including training, intervention, screening, and service integration, that can support nursing home staff to better support residents with SMI and SUD. This narrative literature review examines the literature to identify what is known about this population as well as the current state of care, barriers to better care, and promising practices to support improved outcomes. Using the evidence from the peer-reviewed literature, the authors make recommendations to advance research and practice for this growing population of residents. Strategies to integrate behavioral health services into the nursing home and provide more holistic programmatic social support, behavioral health, and community integration strategies in nursing homes appear to be promising practices.