Policy Changes to Promote Better Quality of Life for People with Serious Mental Illness Living in U.S. Nursing Homes

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As the Baby Boomers age, long-term care systems, including nursing homes (NHs), are accommodating an increasing number of middle-aged and older adults with serious mental illness (SMI). serious mental illness encompasses a range of mental, behavioral, and emotional disorders that result in functional impairments significantly interfering with or limiting life activities (Substance Abuse and Mental Health Services Administration [SAMHSA], 2021). For this article, we classify SMI as encompassing psychotic, bipolar, and treatment-refractory personality, depressive, and anxiety disorders. Many NH residents have co-occurring SMI and dementia (49%; Hua et al., 2021), but NH trainings, practices, and policies primarily focus on dementia care. Clinical management of dementia and SMI require different approaches (e.g., flexibility for dementia, boundaries for SMI; Muralidharan et al., 2019) and NH staff report low confidence for care planning with residents with SMI (Gammonley et al., 2021). For these reasons, more attention to policy, training, and practices for SMI in NHs is needed. Thus, this article focuses solely on SMI.