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Ask Dr. Abrams: Introduction

Like other primary care providers, you may find that your older patients seek mental health assistance from you rather than from mental health specialists. The Surgeon General, in a 2001 report entitled, Older Adults and Mental Health: Issues and Opportunities, sites several reasons for this. Older patients view their primary care practitioners' services as being more convenient and accessible, and less stigmatizing, than the services of mental health providers. Also, Medicare reimbursement encourages this trend, reimbursing primary care practitioners at a higher percentage rate than it does mental health specialists providing the same mental health services.

Yet primary care providers often believe that their own medical education and training has left them unprepared to meet the needs of their older patients' mental health problems. Even the most highly skilled and experienced providers have many questions:
  • What are the signs and symptoms of different psychiatric disorders as they typically present the primary care practitioner?
  • What strategies might I use thelp my older patient accept a diagnosis of depression and be amenable treatment?
  • When are non-medical interventions recommended?
  • What promising psychotropic medications are on the horizon?
  • What are some strategies for discussing difficult mental health diagnosis (for example Alzheimer's Disease) with patients and their families?
  • What is the proper management of medically ill older patients with concurrent mental health problems (e.g., depressive disorders, psychoses, dementia or delirium)?
  • How should a suicidal elderly patient be managed?
If you have ever had any of these or other geriatric mental health questions, then you have come to the right place.

At Weill Medical College of Cornell University's Division of Geriatrics and Gerontology, we care about health care providers working diligently to improve the mental health and quality of life for their older patients. We know that providers with large patient caseloads and too few hours cannot easily research and obtain reliable geriatric mental health information. Compounding this problem is the fact that there are fewer than 2000 practicing geropsychiatrists in the United States today, making their consulting services a scarce resource.

This Web site provides health practitioners with the unique and important opportunity to ask for and receive general geriatric mental health information from a nationally known geriatric psychiatrist, Dr. Robert Abrams, the Director of Geriatric Psychiatry Services in the Division of Geriatric Medicine at Weill Medical College of Cornell University. Dr. Abrams will read all of the questions submitted and will answer a select few at regular intervals by posting his responses on this Web site. Answers to previous months' questions will be archived at this Web site so that readers can easily access them for future reference.

We hope this service helps you in your efforts to improve the health and well being of your older patients.
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