Past Issues

Background: The 10-year long-term care 2.0 plan was launched in 2016 in responding to the challenge of a rapidly aging population in Taiwan. But the needs of middle- and old-aged adults with severe mental illnesses (SMI) may remain unmet because of vague universal umbrella of “people with physical and mentally disability.” In this study, we intended to investigate the pattern of community mental health care services (CMHS) use in Taiwan. Methods: Using the nationwide registered catastrophic illness dataset, we described the use patterns of four CMHS across three age groups – 40-49, 50-59, and 60+ years, from 2002 to 2013. Results: Relatively small proportions, mostly below 5%, of middle-aged and older SMI adults accessed different individual services, regardless of years, age groups, and diagnoses. The most frequently used service was home care (0.51%-6.18%), followed by day care hospital (0.59%-4.88%) and halfway house (0.07%-4.89%), and the least community rehabilitation center (0.02%-3.51%). The use had been increased over time with different patterns and magnitudes across age groups in each type of CMHS. Older SMI adults less frequently used CMHS. Furthermore, lower proportions of CMHS use in SMI patients with affective disorders was found as compared with non-affective psychotic disorders. Conclusion: The present report is the fi rst study to delineate the CMHS use in middle-aged and older SMI adults in Taiwan.