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IN THE ABSTRACTMental Health: A Report of the Surgeon General-Older Adults and Mental Health STUDY AND RESULTS: This report is written as a companion to Mental Health: A Report of the Surgeon General (1999), which was produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute of Health (NIH). The report highlights major issues in the field of mental health and aging and discusses efforts to address these issues, including community-based services. It also gives an overview of the important research, barriers and policy solutions. WHAT'S IMPORTANT: Older Americans have made very little use of mental health services, and only half of older adults who acknowledge mental health problems receive treatment from any health care provider; only a fraction of those receive specialty mental health services. FIND THIS STUDY: U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General-Older Americans and Mental Health. Rockville, Md.: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999. This report also is available online at http://www.aoa.gov/mh/report2001/default.htm
Mental Health Services for the Elderly: Key Policy Elements STUDY AND RESULTS: This chapter of a book examines utilization of mental health services, barriers to services, and funding and revenue sources. It lists patterns of mental health service utilization with inpatient and outpatient services for older adults. The authors found the majority of psychiatric inpatient care (64.5 percent) for those age 65 and older was provided in general hospitals. The elderly also receive disproportionately fewer outpatient services than other groups from community mental health services. The lack of funding and revenue sources for mental health services is addressed in this chapter. Federal funds- including Medicare, the federal share of Medicaid, and block grant funds-accounted for 26 percent of total funding in 1990, while state and local funds accounted for 28 percent. The remaining 46 percent of mental health funding came from out-of-pocket payments, private insurance and philanthropy. WHAT'S IMPORTANT: In the absence of a comprehensive mental health policy for the elderly, older adults will continue to be overlooked in an increasingly fragmented mental health service delivery system. The unique needs of the older adults-both physical and mental-need to be addressed, and general, long-term, and mental health care systems need to work together with, not independent of, each other. It is important that policies and funding strategies at both the federal and state levels permit adequate care for physical, social and mental health needs of the elderly. Mental health systems reform is needed to ensure universal access to the comprehensive mental health benefits that older adults need. FIND THIS STUDY: Estes, Carroll L. Emerging Issues in Mental Health and Aging. Washington, DC.: American Psychological Association Publishers, American Psychological Association, 1995.
Mental Health Services in Assisted Living Facilities and Nursing Homes STUDY AND RESULTS: Analyzing Florida's administrative data, this article presents findings on mental health service use and cost of care for poor older people. There were 7,951 Optional State Supplementation (OSS) adults residing in assisted living facilities; 4,091 (51.4 percent) had at least one Medicaid mental health service claim during the 12-month period. This study found that the demand for assisted living facilities is high and will continue to grow with the aging population. However, to date there is insufficient information to conclude that reimbursement rates for assisted living facilities should be adjusted to account for severity of illness and resource use because many states now provide for nursing home care. WHAT'S IMPORTANT: Meeting the health, mental health and residential needs of older adults presents a major challenge to all states. Assisted living policy is-and will remain-a crucial issue because of the important role assisted living facilities play in the continuum of long-term care for older individuals. Future research should explore the relationship between costs of care and case mix or severity of illness. FIND THIS STUDY: Becker, Marion., Stiles, Paul., and Lawrence Schonfeld. "Mental health service use and cost of care for older adults in assisted living facilities: Implications for public policy." Journal of Behavioral Health Services and Research, 29, no. 1 (2002): 91-98.
Parity Coverage of Mental Health STUDY AND RESULTS: Conducted by the Indiana Division of Mental Health and Addiction, using 1999 Indiana nursing home data, this study found that, within seven days prior to the data collection, 29.3 percent of all nursing home residents in the state had received an antidepressant, 19.8 percent had received antipsychotic medication, and 17.5 percent were given an antianxiety drug. Only 1.1 percent had received any type of psychological therapy. The data indicated that only 8.2 percent of all residents had been evaluated by a mental health professional in the previous 90 days. WHAT'S IMPORTANT: This study reports that medication is the most common treatment for nursing home residents with mental health problems, and the treatment residents receive often does not result from an evaluation by a mental health professional. FIND THIS STUDY: "Parity Coverage of Mental Health," authored by Willard L. Mays. Published in Aging Today (Bimonthly newspaper of the American Society on Aging). 23, no. 3 (2002): 9-11.
Mental Health Services for the Elderly in Maine: A Status Report STUDY AND RESULTS: The Joint Advisory Committee on Select Services for Older Persons submitted this report, issued in January 2000, which addresses the mental health service needs of the elderly in Maine; the extent to which services are available and unavailable; and any information on disparities in unmet need by geographic region, service setting or residential setting. The state of Maine conducted research for this Joint Advisory Committee that included analyses of existing data, which resulted in a list of recommendations to better address the issues of mental health services and the elderly. WHAT'S IMPORTANT: Several pieces of legislation have been introduced as a result of this report, but none have been enacted due to lack of funding in the state's budget. However, this Joint Advisory Committee document can serve as a model for other states that wish to assess their mental health services for older adults and make policy recommendations. The committee's document also led to important state research. FIND THIS STUDY: Duby, Lynn F., and Kevin Concannon. Mental Health Services for the Elderly in Maine: A Status Report. Report by the Joint Advisory Committee on Select Services for Older Persons. Augusta, ME.: Department of Mental Health, Mental Retardation and Substance Abuse Services, January 2000.
Source: Coffey, R. et al. National Estimates of Expenditures for Mental Health and Substance Abuse Treatment, 1997. Office of Organization and Financing, Substance Abuse and Mental Health Services Administration. (SAMHSA. Rockville, MD: July 2000). STATES WITH MENTAL HEALTH AND AGING COALITIONS
Source: National Coalition on Mental Health and Aging. http://www277.pair.com/ncmha/coalitions.php3 State coalitions advocate on behalf of older adults with mental health and/or substance abuse problems by gathering information, serving as a forum for discussion and providing education and information to policy makers, agencies and organizations, service providers and the general public. For further information on mental health services and older adults in your state, these state coalitions serve as excellent resources: Alabama Geriatric Mental Health Association Arizona Behavioral Health and Aging Coalition Arkansas Coalition on Mental Wellness and Successful Aging California Mental Health and Aging Coalition Colorado State Mental Health Services Florida Coalition for Optimal Mental Health and Aging Southwest Georgia Coalition Illinois Coalition on Mental Health and Aging Indiana Mental Health and Aging Coalition Kansas Mental Health and Aging Coalition Kentucky Mental Health and Aging Coalition Louisiana Coalition for the Well-Being of Mature Adults Maryland Coalition on Mental Health and Aging Michigan Advocates for Mental Health and Aging New Hampshire Coalition on Mental Health, Substance Abuse and Aging New Jersey Partners: Aging, Mental Health & Substance Abuse New Mexico Mental Health and Aging Coalition Oklahoma Mental Health and Aging Coalition Pennsylvania Mental Health and Aging Coalition Rhode Island Elder Mental Health Coalition South Dakota Interagency Coalition of Aging Members Texas Mental Health and Aging Coalition Utah Mental Health and Aging Coalition Washington Gatekeepers of Case Finding At-Risk Older Adults Wisconsin Coalition on Mental Health, Substance Abuse and Aging
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