A FOUR-YEAR REVIEW OF GERIATRIC MENTAL HEALTH SERVICES.IN A LAGOS BASED HOSPITAL, NIGERIA
Bibliographic record
Abstract
Background: There is a growing global concern about the public health implications of the increasing population of the elderly. One main issue of concern is centered on how to address their mental health needs using homegrown interventions and services. We expect that important lessons on geriatric mental health issues would be brought to fore in this report. Methods: This is a four-year (2007-2011) retrospective report on the mental health services rendered to 938 clients aged 60 years and above at a Lagos based mental health treatment facility in Nigeria. Designed questionnaires were filled with socio-demographic and clinical data obtained from patients case notes based on the objectives of the study. Results: The mean (standard deviation) age of elders was (±7.93) 69.6 years, and 65.5% were females. Majority were married, self-employed and belonged to low socio-economic status (73.1%, 63.1% and 63.2%, respectively). Close to two-thirds (62.4%) commute for at least one hour to get treatment. The commonest diagnosis was psychotic disorders (34.8%), while 5.5% had Alzheimer’s dementia. Some 96.5% of the elders were solely on medications. About a quarter had past history of mental illness and 48.5% reported co-morbid medical conditions, with cardiovascular problems (53.0%) being the commonest physical comorbidity. The middle old along with very old elders (aged≥70 years), and those with at least tertiary education, were more likely to present with dementia were more likely to present with index episode of mental illness and receive outpatient care Conclusion: The elders were managed for a wide range of treatable mental illnesses and other comorbidities and commute for hours to access care. Pharmacotherapy was the preponderant sole treatment modality. There is need for sustained development of expertise to enhance multimodal care and scaling up of comprehensive geriatric mental health services. Further research is needed on how to appropriately link and/or integrate geriatric care with services at all-tiers of health care delivery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".