AbstractThe prevalence of organic impairment, depressive illness and anxiety was assessed in 32 subjects (group A) within two weeks of admission to one of four local authority homes for the elderly in Fife, Scotland. This group was compared with an age and sex matched control group (group B) who continued to live at home. Both groups were reinterviewed six months later.Levels of organic impairment, depression and anxiety were significantly higher in group A at the time of admission. At follow‐up, levels of organic impairment and depression remained unchanged in both groups. The level of anxiety was significantly lower in group A but remained unchanged in group B at follow‐up.Forty per cent (13 subjects) of group A were diagnosed at first interview as suffering from major depressive episode, minor depressive disorder, generalized anxiety disorder and/or phobic disorder but no‐one was receiving treatment.This study reinforces the case for specialist assessment prior to admission to residential care as advocated by the British Geriatric Society. Improved liaison between social and psychiatric services is essential if psychiatric morbidity in the elderly is to be identified and treated, and residential places are to be used appropri