Scaling Supply to Meet Behavioral Health Demand in New York State Nursing Homes

Abstract

Summary Nursing home residents’ need for behavioral health services is ever-increasing, and the Covid-19 pandemic exacerbated problems in behavioral health involving: (1) access, (2) quality of care, (3) care continuity, and (4) staff education. This case study describes a novel behavioral health program developed at the University of Rochester (UR) to optimize limited clinical resources and address unmet behavioral health needs of New York State’s long-term care residents. To deliver effective behavioral health services in nursing homes, UR’s behavioral health program has four components: onsite psychiatric nurse support, telepsychiatry, telepsychotherapy, and telementoring. Prior to the Covid-19 pandemic, this behavioral health program provided services to 29 nursing homes. Over 2 years (2017 to 2019), antipsychotic use among long-stay residents in these homes decreased by 37%. During the Covid-19 pandemic, the program’s services expanded to 53 nursing homes. In contrast to increasing antipsychotic use at the national and state levels, long-stay resident antipsychotic use among program nursing homes decreased. With demonstrated success in improving access and outcomes at lower cost, the New York State Office of Mental Health has funded the program’s expansion to nursing homes across the state.