Coalitions on mental health and aging are not new. For example, interagency cooperation between the aging network and the public mental health system began in Michigan in 1978, and the state of Michigan established a council on mental health in 1988. AARP’s Program Division convened an internal Task Force on Mental Health and Aging in 1989. Dr. Kermit Phelps chaired this effort funded by the Health Care Campaign. In 1990 this group recommended that AARP investigate the possibility of forming an national coalition. We hired a firm, the Communication Consortium to collect this information. They contacted 23 organizations to investigate the interest in forming a coalition.

The National Coalition on Mental Health & Aging was formed by a group of organizational members representing the disciplines that work in aging and mental health as a result of the first meeting held in February of 1991. With leadership from AARP, there was a strong spirit of consumer involvement and empowerment within the Coalition. Through the work of the Social Outreach and Support Section within the Programs Division, AARP agreed to initially sponsor the Coalition of two years. After two years this commitment was investigated and AARP decided to continue providing the staff and financial support to foster the ongoing work of the coalition. AARP continued to provide support until 2001, when in June of that year, the American Psychological Association (APA) became the second organizational host of the NCMHA. Since that time the APA Office on Aging has provided the Coalition with staff and in-kind financial support.

Selected Examples of Early Coalition Activities

1991

The first meeting hosted by AARP brought together organizational representatives from aging, professional consumer family mental health and government settings. The Coalition model was seen as way to unify professionals, consumers and government representatives so that together they could work towards improving the availability and quality of mental health services to older Americans. The Coalition was organized to address the mental health service needs of older persons, through:

  • advocating on behalf of appropriate mental health treatment and care for older persons;
  • decreasing the prevailing stigma associated with mental and emotional problems;
  • improving access to mental health services;
  • drawing attention to the importance of emotional well-being, prevention and self-help programs for elders;
  • educating professionals, the general public, decision-makers and older individuals on the mental health issues of our older population; and
  • encouraging older persons to use the services of mental health professionals, volunteer programs and self-help programs.

Early Activities included the development of the statement of purpose and bylaws and the creation of core subcommittees: Public Education, Education of Policy Makers, State and Local Coalition Development. Early coalition activities fostered a number of joint ventures between organizations.

1992

Over time the potential for collaborative efforts between organizations increased, demonstrated by a number of interdisciplinary efforts between the professional organizations (i.e. social workers planning a presentation with psychiatry).

  • The American Psychological Association solicited input from other member organizations in the development of a videotape. Through contacts with the Coalition, the National Mental Health Association (NIMH) was able to have their local MHA affiliates connect with many local AARP chapters linking aging and mental health representatives at the local level
  • AARP Linkage project support fosters the development of an Oklahoma Coalition.
  • Articles about the Coalition appear in the AARP Bulleting and in NMHA
  • March 1992 Coalition cosponsors a one day pre-conference workshop on Aging and the Emerging Spirit at the American Society on Aging Conference
  • April 1992 AARP internal review results in a decision to continue support of the Coalition
  • May 11, 1992 a public service packet & Press Conference: To Tell the Truth
  • Other workshops at NASMHPD October, 1992
  • Presentation on the work of the coalition at the GSA meeting in November 1992

1993

July 15, 1993: The Coalition and AARP hosted A Capitol Hill Forum: Efficacy and Effectiveness of Mental Health Services for Older Persons, presenting it to the Senate Aging Committee. Committees continued to develop special projects and cooperative presentations at member organizational conferences continues.

1994

We focused on general promotion efforts and began planning for the 1995 WHCoA.

Series of audio and video public services announcements

  • Educational Packet for Members and Others 4/94
  • Audio and Video Spas distributed through member affiliates nationwide

1995

A manual “Building State and Community Mental Health and Aging Coalitions — A How-To Guide”

White House Conference on Aging, mini conference on Emerging Issues in Mental Health & Aging

  • Published proceedings from the mini conference
  • Hill briefing with release of the book

1996

Convened the Forum on Managed Care, Mental Health & Aging and printed and disseminated its proceedings.

1998

The Coalition Building Project was launched by the National Coalition on Mental Health and Aging, the AARP Foundation and the Center for Mental Health Services. The project trained diverse networks of elderly and mental health service providers and consumers at the state and local levels.

1999

Held a Special Conference devoted to identifying existing and emerging challenges to the delivery of quality mental health care for elder persons, and to formulating recommendations and developing innovative ways to meet these challenges in the new millennium.

2002

A representative of NCMHA provided testimony to the President’s New Freedom Commission on Mental Health.

2004

A representative of NCMHA provided testimony to the Public Policy Committee of the 2005 White House Conference on Aging (WHCoA) to encourage that mental health and substance abuse issues be considered in their deliberations and recommendations.

2005

Sponsored a 2005 WHCoA Listening Session on Mental Health and Aging.

Successfully advocated for the inclusion of mental health and health workforce issues in the top 10 resolutions of the 2005 White House Conference on Aging.

2006

Expanded membership to be inclusive of state and local coalitions on mental health, substance abuse and aging.

Conducted workshops on mental health and aging at the SAMHSA/CMS Invitational Conference on Medicaid and Mental Health Services and /Substance Abuse Treatment and the 6th Annual SAMHSA.

2007

Cosponsored a Congressional Briefing, Promoting the Mental Health of Older Adults: An Action Agenda for an Aging America with the Older Women’s League and the American Psychological Association and Congressional cosponsors, Sens. Tom Harkin (D-IA), Gordon Smith (R-OR), Hillary Rodham Clinton (D-NY), and Susan Collins (R-ME)

Cosponsored a full day track on mental health and aging coalitions titled, Mental Health and Aging Coalitions: Effective Approaches and Innovative Practices at the American Society on Aging/National Council on Aging Joint Conference

2008

Cosponsored a Mental Health and Aging Coalition Track, Aging in America: Mental Health and Aging Coalitions Make a Difference! at the Aging in America Conference

2010

Submitted recommendations on the reauthorization of the Older Americans Act related to the mental health and elder abuse provisions

Submitted specific recommendations to SAMSHA requesting systematic consideration to the special needs of older adults in each of the areas of its Strategic Initiatives

2011

Conducted an online survey to identify and learn about the structures, activities, areas of need, and contact information for state and local coalitions on mental health and aging

2012

Developed four priority areas for NCMHA’s current efforts: assure access to services; integration of behavioral health into primary health care, long term services and supports and community services; designation of older adult mental health leader/coordinator in federal and state agencies; and address severe provider and faculty shortages

Provided comments to SAMHSA on the proposed Uniform Application for the Mental Health Block Grant and Substance Abuse Block Grant FY 2014-2015 Application Guidance calling upon the agency to encourage states to address the needs of older adults for mental health promotion and prevention, and treatment of substance use disorders

Provided Comments on the Draft National Plan to Address Alzheimer’s Disease requesting that the final plan will be more cognizant of the significant mental and behavioral health issues associated with Alzheimer’s Disease for which there are effective interventions and supports

2013

Sent letters to key federal agency leaders asking that a high level contact be established with NCMHA and offering assistance in efforts to address the recommendations of the 2012 IOM Report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands

Provided recommendations to SAMHSA related to consumer engagement, evidenced-based behavioral health practices with older adults, and adding more specifics related to geriatric mental health in block grant funding and reporting

Developed and disseminated talking points for SAMHSA’s Community Conversations about Mental Health including an overview of older adult mental health needs, why older adult mental health matters, and actions which can be taken to address these needs

Provided data-based comments to Commission on Long-Term Care detailing the reasons why a national strategy to form a viable, community-based long-term care system must address the mental and behavioral health challenges of this population

2014

Developed a Directory of Competencies, Standards, and Guidelines for Practice with Older Adults with Mental and Behavioral Health and Substance Abuse Issues to address the severe practitioner and faculty shortages in mental health, behavioral health, and substance abuse

A one-year grant from the Retirement Research Foundation is awarded to The Mental Health Association of NYC to enable NCMHA to develop a national learning community to enhance the capacity to address older adult behavioral health issues in state long-term care rebalancing efforts

Submitted a response to proposed CMS Rule Changes on the Medicare Prescription Drug Benefit Programs

Presented oral remarks for SAMHSA listening session on Protecting Access to Medicare Act of 2014 Sec. 223: Criteria for State-Certified Community Behavioral Health Clinics

2015

Encouraged SAMHSA and HHS to modify the Criteria for State-Certified Community Behavioral Health Clinics to provide attention to older adults and collaboration with aging services via both oral and written testimony

Provided comments to SAMHSA on their 2015-2018 Strategic Plan commending them for their inclusion of older adults in a few of the strategic initiatives but raising their omission of older adults in the goals to prevent and reduce suicide among populations at high risk and to develop the behavioral health workforce

Developed and submitted recommendations for the 2015 White House Conference on Aging

Prepared and distributed a detailed Resource List of NCMHA member offerings in recognition of Older Adult Mental Health Week

Conducted, with the state coalitions, a needs assessment on current long-term care reform efforts and their relationship to behavioral health

Held a peer group session and two full day programs related to clinical issues and policy initiatives at the 2016 Aging in America Conference

Provided comments to CMS on its proposed Reform of Requirements for Long Term Care Facilities recommending the inclusion of the SAMHSA definition of recovery and that any rules pertaining to behavioral health must be specific and clear given the high rate of behavioral health disorders in facilities

2016

Provided guidance to state and local mental health and aging coalitions within states awarded planning grants from SAMHSA’s National Certified Community Behavioral Health Clinics (CCBHC) 223 Demonstration Program

Conducted a NCMHA Membership Survey to gather members’ input on major older adult behavioral issues of importance and ways to best engage the membership

Co-hosted a twitter chat with the National Council for Behavioral Health on Older Adults & Mental Health to raise awareness about older adults at risk or living with mental health disorders in recognition of Older Americans Mental Health Week

Partnered with the NASMHPD Older Persons Division to survey state mental health agencies to determine the status of older adult mental health services and mental health and aging coalitions in the states and whether there is interest in developing a coalition

Worked with state coalitions in eight states on mental health and aging to establish a learning community for further integration of older adult behavioral health into state-based long-term care with the support of the Retirement Research Foundation

Identified six organizations interested in becoming NCMHA members

Submitted a response in opposition to Proposed CMS Rule Changes on the Medicare Prescription Drug Benefit Programs to exclude antidepressants and anti-psychotics from protected status which would be harmful to the quality of life of older adults with mental health challenges

2017

Fostered the development of a partnership between NCOA, the VA, and ACL to meet mental health and other needs of veterans through an invited VA presentation on partnership development at a NCMHA Coalition meeting

2018

Cosponsored a Congressional Briefing, Addressing the Crisis in Older Adult Mental Health, to encourage members of Congress to advocate for

expanded mental health services and access to care for older adults through legislative and regulatory initiatives, and increased funding with Congressional cosponsors Reps. Grace Napolitano (D-CA) and John Katko (R-NY) Co-chairs of the Congressional Mental Health Caucus

Cosponsored the first ever National Older Adult Mental Health Awareness Day with SAMHSA and ACL designed to raise public awareness, promote evidence-based interventions, and increase collaboration between the mental health and aging networks to address the mental health needs of older adults the day following the Congressional briefing

Established a work group to develop a white paper to follow-up on the above events related to mental health and behavioral health services, financing and coverage, education, and workforce development

Provided oral and written comments to the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) supporting their attention to effective Medicare policies and programs to address the needs of older adults with SMI and providing details on the specific needs and effective interventions for older adults with SMI and their caregivers