Highlights
- •What is the primary question addressed by this study?Has the prevalence of serious mental illness (SMI) in assisted living (AL) increased in recent years?
- •What is the main finding of this study?Rates of SMI in AL increased between 2007 and 2017 at a rate faster than the community but slower than in nursing homes. We found substantial between- and within- state variability in the percentage of residents with a diagnosis of SMI.
- •What is the meaning of the finding?Given the increased prevalence of SMI in AL, research is needed into the care needs of this population.
ABSTRACT
Objective
Little is known about the prevalence of serious mental illness (SMI) in assisted living
(AL) communities in the United States. Trends in the prevalence of SMI in AL communities
were examined over time and in relationship to characteristics such as dual eligibility
and health conditions. Within- and between-state variability of SMI in AL was also
examined.
Design
Samples of Medicare beneficiaries who lived in the 48 contiguous states were created:
individuals who resided in the community, in a nursing home (NH), and in an AL community
on December 31st of each year (2007–2017). We conducted univariate analysis to display
the trends in SMI over time in AL compared with NHs and the community. To demonstrate
intrastate variability, we examined the prevalence of SMI for each state. We described
within-nation and within-state variability using a Lorenz curve and GINI coefficients,
respectively.
Results
The prevalence of SMI in AL increased by 54%, rising from 7.4% in 2007 to 11.4% in
2017. Residents with SMI were more likely to be dually eligible for Medicare and Medicaid
than residents without SMI. The prevalence of SMI in AL ranged from to 3.2% in Wyoming
to 33.1% in New York. Approximately 10% of AL communities had over half of the sample's
AL residents with SMI.
Conclusion
Given the increased proportion of residents with SMI in AL, research is needed into
the mental health and social care needs of this population. Analysis is needed to
uncover reasons for variations among states.
Key Words
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Article info
Publication history
Published online: September 18, 2020
Accepted:
September 15,
2020
Received in revised form:
September 11,
2020
Received:
August 3,
2020
Identification
Copyright
© 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
