January 2005
- New Philadelphia Behavioral Health Project for Older Adults to Be Launched on February 4, 2005!
- Seniors Focus on PA
- State to Cut Older Adult Pilot Projects
- Older Hispanics Struggle to Find Hope
- National Conference Here to Focus on Creating Comprehensive System
- The Season of the Silent Epidemic
New Philadelphia Behavioral Health Project for Older Adults to Be Launched on February 4, 2005!
A new partnership that brings together Aging Services, the Behavioral Health System and Medicare HMOs to improve behavioral health services for older adults will be unveiled on Friday, February 4, at 1PM in the City Council Chambers (Room 400) at Philadelphia City Hall. All are welcome!
The program will expand in-home mental health services to older adults throughout Philadelphia and establish a new pilot project to integrate behavioral health, physical health, and aging services.
The program is the result of persistent advocacy by older adult consumers, senior centers, City Council members, providers, and individual advocates. In 2002, at a public hearing on the lack of mental health services for older adults before the Health and Human Services Committee, Council member Blondell Reynolds-Brown and many others called for a comprehensive plan to improve services for older adults at risk for mental illness. The committee directed the Philadelphia Corporation for Aging and the Philadelphia Office of Behavioral Health and Mental Retardation Services to develop a workgroup to create a plan to address the lack of services.
Expected at the signing ceremony are representatives from the Philadelphia Corporation for Aging, the Behavioral Health System, Aetna, Blue Cross, and Americhoice.
Seniors Focus on PA
During the spring and summer, a new initiative by the Pennsylvania Mental Health and Aging Coalition and Estelle Richman, Pennsylvania's Secretary of Public Welfare, was implemented to develop recommendations to make mental health and substance abuse services more accessible to older adults.
Twenty-three focus groups were convened throughout Pennsylvania. The groups consisted of consumers, providers, older adults who were not consumers, advocates, and family members of consumers. Generally, the groups were homogeneous. Some of the groups were conducted in English, some in Spanish, and others in Korean. Participants were asked about barriers to services and what could be done to overcome them. The findings varied, depending on ethnicity, language, location, group identity, and citizenship. While there will be a public announcement in the near future about the results of the groups, we thought that you might like a preview of some of the themes we heard.
"One of the biggest barriers to getting help: not knowing."
Although, there is a need for additional services for older adults, some older adults are not aware of existing services. This is particularly true regarding non-English-speaking older adults, where barriers included lack of cultural sensitivity and language. Some of the comments heard from a non-English-speaking group were that "mental illness is feared, not understood," and that "depression is associated with many stressors of older adult life, and alcohol or drug problems predominate." One person said that "a doctor is not someone you confide in."
For many, the lack of knowledge led to stigma and misunderstandings as to how to get better. Many thought that depression was a normal part of aging. Some even thought that suicide was an acceptable way out of life for some people who couldn't feel better.
"Getting better involves getting out, getting treatment, and getting connected."
Many older adult consumers shared insights into what helps them get better. These included the basics of a good, healthy life, such as limiting stress and taking a walk when you feel down. Others shared some of the hurts and discrimination that they have experienced from the stigma of mental illness. Said one person, "When older adult consumers experience the stigma of having mental illness/substance abuse, it keeps them from getting services, and isolates or punishes those who are struggling with problems."
"Many older adults end up in nursing homes due to system failures."
Providers were sensitive to the fact that "there are some systemic barriers that prevent care." Some were critical of primary care physicians but recognized their important role. Most providers thought that older adults didn't understand mental illness and its connection to their physical health.
Unanswered Questions
As we read the responses of the various groups, we could see that there were some concerns and questions that were voiced by more than one group. For example, primary care doctors play an important role in the lives of older adults but need assistance to maximize the care that they provide for them. What should their role be? Another frequently mentioned area is depression: what it is or is not. Is it treatable without professional help? How can we help older adults overcome the stigma attached to it due to lack of information? How do we confront the view that suicide is an increasingly acceptable alternative to old age and that depression is a major issue? These are just a few examples of the issues that need to be addressed as we work to improve the system.
There is much more that can be learned from the groups. We hope to have regional meetings throughout the state to share all the results. Then we hope to begin education and training sessions to help all the groups learn how important they are in improving the mental health of older adults in Pennsylvania.
As a result of the focus groups, the Pennsylvania Mental Health and Aging Coalition developed recommendations that will be presented to the state and the public early in 2005.
Thank you for helping make 2004 a productive year. Have a healthy 2005!
-Corbitt Banks, 215-751-1800, ext. 207
State to Cut Older Adult Pilot Projects
Because of cuts in the Federal Mental Health Block Grant, the Pennsylvania Office of Mental Health and Substance Abuse Services is proposing to cut the $1.1 million funding in half this year and then eliminate six mental health and aging pilot projects throughout Pennsylvania.
The six pilot projects - in Erie, Green, Cameron-Elk-McKean, Carbon-Monroe-Pike, Schuylkill, and Beaver counties - were created to address the lack of mental health services for older adults.
The Office of Mental Health and Substance Abuse Services named these as some of the results of the programs:
- An increase in utilization of generic community resources;
- An increase in mental health utilizations;
- Few admissions to psychiatric facilities of those referred to the project;
- Few admissions to nursing homes of those referred to the project;
- No reported suicides of those referred to the project.
The Older Adult Committee of the Mental Health Planning Committee has refused to endorse the cuts. Advocates claim that it is time to use the lessons learned from the pilot projects to establish behavioral health services for older adults in the whole Commonwealth, not to cut funding.
The Mental Health/Aging Advocacy Project and the Pennsylvania Mental Health and Aging Coalition are urging members to write to Deputy Secretary Joan Erney to encourage her to find funding for the programs. Below is a sample letter.
Joan L. Erney, Deputy Secretary for Mental Health and Substance Abuse Services Department of Public Welfare P.O. Box 2675 Harrisburg, PA 17105-2675
Dear Deputy Secretary:
I am writing to protest the move to cut funding for the six mental health and aging pilot programs in Pennsylvania.
Pennsylvania has the second largest percentage of older adults; yet, out of a $1 billion budget, it spends only a tiny amount of funds for older adults who have depression, anxiety, and other mental health problems. Now even that money will be taken away.
We urge you to restore the funds so they can serve older adults.
Thanks,
(Your name and contact information)
Older Hispanics Struggle to Find Hope
By Domingo Nieves
The Latino focus group that was held this summer at Kennett Square was one of those experiences that stay with you for a long time. The faces of older adults that reflected a deep sense of helplessness will be hard to forget.
As part of the effort to access barriers to older adults receiving behavioral health services, I facilitated two focus groups. The Latino population in the area is very mixed, with Puerto Ricans, Mexicans, Dominicans, and others.
We were shocked at some of the conditions that the Latinos live in. Because of their illegal status in this country, this group has to put up with discrimination and violation of their human rights. Some of the politicians were seen as particularly vindictive and there is no one to challenge the status quo because of fear of retribution.
The problems of depression in older adults lead many to seek escape in alcohol. On top of all these problems is the language barrier. It seemed as if they were in a mental cage and were scared of looking for help for fear of deportation.
Before we left, I asked a person to send me information about these issues, but nothing has come.
I believe that Pennsylvanians can do better for these older adults who so desperately need some basic medical and mental health services. If you want to contact me, call 215-751-1800, ext. 336.
National Conference Here to Focus on Creating Comprehensive System
Philadelphia will be this year's site of the National Council on Aging/American Society on Aging annual conference, called The Changing Face of Aging. This event is set to bring some 4,000 aging-field professionals and advocates to Philadelphia from March 9 through 13 to hear about aging issues.
The Mental Health and Aging Project has organized a pre-conference workshop entitled, Moving From Programs That Work to a Continuum of Care for Older Adults At Risk for Behavioral Health Problems.
The workshop will bring together a number of national and local experts to focus on issues, programs, and systems around the development of an integrated way of caring for older adults with behavioral health needs.
This all-day, intensive workshop will present a combination of clinical practices and systems changes that can create such a system. It will begin with an overview of clinical and policy issues in behavioral health services for older adults affecting mental health and aging programs on the local, state, and national levels. It will then focus on key components of clinical best practice models of cross-training staff, community integration, in-home treatment, and co-location (placing mental health workers in health clinics or health workers in mental health centers). Practical ways to change the system also will be presented. A highlight of the day will be a presentation by a panel of older adult consumers speaking out on what they see as essential ingredients for reaching people who are hard to reach.
Older adults are able to participate at no charge by volunteering. A form is available at the end of the newsletter.
The Season of the Silent Epidemic
By Hikmah Gardiner
By now that jolly old rotund gent and his tiny reindeer have returned to the North Pole, evergreen trees have been taken down and decorations carefully packed away for another year. I trust everyone enjoyed their holidays.
However, there are some folks for whom this season is fraught with sadness and misery. Depression occurs any time of the year, but it can be particularly devastating during the early winter months.
It has been named by some as "The Silent Epidemic." Society does not want to talk about it. Often, those who have it don't know what it is and, if you are an older person, society believes that it's a part of normal aging - which, by the way, is simply not true.
Some of the signs of depression in elderly people are as follows:
- Feelings of worthlessness;
- Sleep and appetite disturbances;
- Hopelessness;
- Thoughts of suicide;
- Not interested in cleanliness, grandkids, church, etc.
If you have some of these signs, be sure that you speak with your doctor, minister, family members, or a real good friend. Let them know what is going on with you. Do not just sit there and suffer in silence. There is help for you.