LATEST RESOURCES
NCMHA would like to share the following new resources in long term care and behavioral health:
June 2, 2022
During Mental Health Awareness Month and Older Americans Month, the Alliance for Aging Research released a series of tip sheets for clinicians. These tip sheets share important information on diagnosis, treatment, and having important conversations with patients and their caregivers.
NCMHA thanks Lindsay Clarke with the Alliance for Aging Research for sharing these Tip Sheets.
- Alzheimer’s Disease & Related Dementiasfocuses on detection in the primary care setting, screening tools, the importance of early detection, tips for discussing an initial diagnosis, communication changes to expect as dementia progresses, shaking the stigma of common behavior changes, and tips for caregivers on communicating with loved ones.
- Depression & Suicide in Older Adults talks about why older adults are at heightened risk for depression, the difficulties of detection, screening tools and reimbursement, important conversations and how to have them, how to detect if a patient is suicidal, and additional resources.
- Substance Use Disorders & Mental Health in Older Americans discussed increased risk for substance use disorders [SUDs] in older adults, why they tend to be under-recognized and under-treated, screening tools, important conversations, and where to learn more.
These mental health tip sheets are designed to give easy access to screening tools and make difficult conversations easier. Please feel free to download, print, and share them.
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May 11, 2022
Hi NCMHA Members,
I have included links to two new reports on opportunities to address the needs of older adults with substance use conditions.
The first report appeared in Health Affairs entitled, ” To Care for Older Adults with Substance Use Disorder: Create Age-Friendly Health Systems.” The report calls for efforts where older adults with substance use disorders must be able to access evidence-based treatment in age-friendly settings wherever they receive clinical care.
https://www.healthaffairs.org/do/10.1377/forefront.20220505.917481/
The second report was developed by the Bipartisan Policy Center (BPC) on “Combating the Opioid Crisis: Smarter Spending to Enhance the Federal Response.” This report calls on the federal government to do a better job in partnering with all those impacted — states, localities, businesses, non-governmental organizations, patients and families — to support a system promoting prevention, treatment, harm reduction, and recovery from opioid use disorder. BPC said we need to fund evidence-based programs to maximize reductions in overdose deaths and addiction. It makes several recommendations to leverage the Medicare and Medicaid programs to support these initiatives.
I hope you find this information useful, and please let me know if you have any questions.
Joel E. Miller
Chair
National Coalition on Mental Health and Aging
National Mental Health Awareness Month (MHAM)
Hello NCMHA Members,
With National Mental Health Awareness Month (MHAM) approaching in May, the National Coalition on Mental Health and Aging (NCMHA) has developed a set of materials (see below for attachments and links) that you can use to post on your websites or forward to your members and audiences emphasizing “The Growing Need to Address Older Adult Mental Health Issues” during the month of May.
In addition to the attachments and links, please go to our website at http://www.ncmha.org for additional information, and post content about the Coalition and older adult mental health issues on your sites and platforms.
We recognize that you will be posting content for MHAM in May that pertains to your specific organization’s needs and interests, but we hope you will consider carving out opportunities during May to highlight your participation in the National Coalition on Mental Health and Aging, and the needs of older adults with mental health conditions using any of the attached materials and our website content.
Please let us know what your plans are for posting any content or themes to observe Mental Health Awareness Month.
We hope you find the information provided below and attachments useful, and please let us know if you have any questions. And please let us know if you post and forward any of these materials during May – Mental Health Awareness Month.
Many Thanks!
Best regards,
Joel E. Miller
Kathy Cameron
Chair, NCMHA Vice-Chair, NCMHA
NCMHA White Paper on “Why Older Adult Mental Health Matters”
NCMHA – SNAPSHOT OF THE CRISIS IN OLDER ADULT MENTAL HEALTH
NCMHA Statement to Ways and Means Committee (Lengthier Version Sent to Senate Finance Committee) on “Addressing America’s Mental Health Crisis to Improve Access to Behavioral Health Services for Older Adults”
COMMONWEALTH FUND REPORT – Comparing Older Adults’ Mental Health Needs and Access to Treatment in the U.S. and Other High-Income Countries
See Exhibit 5 – Among older adults with mental health needs, U.S. Medicare beneficiaries were the most likely to report cost-related difficulties getting needed health care.
The Commonwealth Fund survey asked older adults about times when cost prevented them from accessing health care in the past year, including when they had a medical problem but did not visit a doctor; skipped a needed test, treatment, or follow-up; did not fill a prescription for medicine; or skipped medication doses.
Despite the financial protections Medicare offers, its coverage leaves many U.S. older adults exposed to high health care costs. This is particularly true for beneficiaries with serious mental health needs who are likely to spend more on health services. High out-of-pocket health costs can lead beneficiaries to postpone care or forgo it entirely, which can produce poorer health outcomes and raise overall health care spending.
U.S. Medicare beneficiaries have one of the highest rates of mental health needs overall. Even so, they are more likely to skip or delay needed care because of costs than older adults in any other of the high-income countries we studied. Within the Medicare population, beneficiaries with mental health needs are more likely to skip care compared to those without mental health needs.
KAISER FAMILY FOUNDATION REPORT – One in Four Older Adults Report Anxiety or Depression Amid the COVID-19 Pandemic.
Amid the ongoing coronavirus pandemic, Kaiser’s analysis finds rates of depression and anxiety are high among adults ages 65 and older relative to rates in 2018, with one in four reporting anxiety or depression during most weeks since the onset of the pandemic – an increase from one in ten older adults who reported anxiety or depression in 2018. Rates of anxiety or depression among older adults were higher among those who are female, Hispanic, low income, in relatively poor health, who live alone, or who have experienced the recent loss of employment income in their household.
SAMHSA – Older Adults Living with Serious Mental Illness: The State of the Behavioral Health Workforce
The purpose of this brief is to provide a broad-based overview of workforce issues to consider when addressing the needs of older adults living with SMI,
The needs and growth of the older population with SMI exceeds the number of behavioral health providers that are trained in geriatric care. Further, the workforce that works most frequently with geriatric populations (primary care physicians, assisted living and nursing home staff, emergency department staff, inpatient hospital staff, and family members) are not routinely trained in how to recognize or effectively address SMIs.
SAMHSA – Psychosocial Interventions for Older Adults with Serious Mental Illness
The guide presents psychosocial interventions for older adults experiencing serious mental illness, including: Assertive Community Treatment, Cognitive Behavioral Social Skills Training, Functional Adaptation Skills Training, Programa de Entrenamiento para el Desarrollo de Aptitudes para Latinos (Functional Adaptation Skills Training Program for Latinos), Integrated Illness Management and Recovery, and Helping Older People Experience Success. The guide provides considerations and strategies for interdisciplinary teams, peer specialists, clinicians, registered nurses, behavioral health organizations, and policy makers in understanding, selecting, and implementing evidence-based interventions that support adults with serious mental illness.
A Hidden Gem: How HCBS Can Support the Behavioral Health Crisis
Source: #Crisis Talk, Innovations, April 5, 2022
Author: Miriam Pearsall, Roxana Rodriguez, and Laura Blanke
A Hidden Gem: How HCBS Can Support the Behavioral Health Crisis Continuum – #CrisisTalk (crisisnow.com)
Washington State Retools First-in-the-Nation Long-Term Care Benefit
Source: Kaiser Health News, April 18, 2022
Author: Michelle Andrews
Washington State Retools First-in-the-Nation Long-Term Care Benefit | Kaiser Health News (khn.org)
“The Growing Need to Address Older Adult Mental Health Issues”
With National Mental Health Awareness Month (MHAM) approaching in May, the National Coalition on Mental Health and Aging (NCMHA) has developed a set of materials (see below for attachments and links) that you can use to post on your websites or forward to your members and audiences emphasizing “The Growing Need to Address Older Adult Mental Health Issues” during the month of May.
In addition to the attachments and links, please go to our website at http://www.ncmha.org for additional information, and post content about the Coalition and older adult mental health issues on your sites and platforms.
We recognize that you will be posting content for MHAM in May that pertains to your specific organization’s needs and interests, but we hope you will consider carving out opportunities during May to highlight your participation in the National Coalition on Mental Health and Aging, and the needs of older adults with mental health conditions using any of the attached materials and our website content.
Please let us know what your plans are for posting any content or themes to observe Mental Health Awareness Month.
We hope you find the information provided below and attachments useful, and please let us know if you have any questions. And please let us know if you post and forward any of these materials during May – Mental Health Awareness Month.
NCMHA White Paper on “Why Older Adult Mental Health Matters”
NCMHA Fact Sheet — “A Snapshot of the Crisis in Older Adult Mental Health”
See Exhibit 5 – Among older adults with mental health needs, U.S. Medicare beneficiaries were the most likely to report cost-related difficulties getting needed health care.
The Commonwealth Fund survey asked older adults about times when cost prevented them from accessing health care in the past year, including when they had a medical problem but did not visit a doctor; skipped a needed test, treatment, or follow-up; did not fill a prescription for medicine; or skipped medication doses.
Despite the financial protections Medicare offers, its coverage leaves many U.S. older adults exposed to high health care costs. This is particularly true for beneficiaries with serious mental health needs who are likely to spend more on health services. High out-of-pocket health costs can lead beneficiaries to postpone care or forgo it entirely, which can produce poorer health outcomes and raise overall health care spending.
U.S. Medicare beneficiaries have one of the highest rates of mental health needs overall. Even so, they are more likely to skip or delay needed care because of costs than older adults in any other of the high-income countries we studied. Within the Medicare population, beneficiaries with mental health needs are more likely to skip care compared to those without mental health needs.
Amid the ongoing coronavirus pandemic, Kaiser’s analysis finds rates of depression and anxiety are high among adults ages 65 and older relative to rates in 2018, with one in four reporting anxiety or depression during most weeks since the onset of the pandemic – an increase from one in ten older adults who reported anxiety or depression in 2018. Rates of anxiety or depression among older adults were higher among those who are female, Hispanic, low income, in relatively poor health, who live alone, or who have experienced recent loss of employment income in their household.
The purpose of this brief is to provide a broad-based overview of workforce issues to consider when addressing the needs of older adults living with SMI,
The needs and growth of the older population with SMI exceeds the number of behavioral health providers that are trained in geriatric care. Further, the workforce that works most frequently with geriatric populations (primary care physicians, assisted living and nursing home staff, emergency department staff, inpatient hospital staff, and family members) are not routinely trained in how to recognize or effectively address SMIs.
SAMHSA – Psychosocial Interventions for Older Adults with Serious Mental Illness
The guide presents psychosocial interventions for older adults experiencing serious mental illness, including: Assertive Community Treatment, Cognitive Behavioral Social Skills Training, Functional Adaptation Skills Training, Programa de Entrenamiento para el Desarrollo de Aptitudes para Latinos (Functional Adaptation Skills Training Program for Latinos), Integrated Illness Management and Recovery, and Helping Older People Experience Success. The guide provides considerations and strategies for interdisciplinary teams, peer specialists, clinicians, registered nurses, behavioral health organizations, and policy makers in understanding, selecting, and implementing evidence-based interventions that support adults with serious mental illness.
Climate Change and the Mental Health of Older Adults
Coping with Extreme Heat – Toolkits for Patients, Caregivers, and Professionals:
Toolkit for Mental Health Care Providers
Tips for Caregivers and Families
Psychosocial Interventions for Older Adults With Serious Mental Illness
The guide provides considerations and strategies for interdisciplinary teams, peer specialists, clinicians, registered nurses, behavioral health organizations, and policy makers in understanding, selecting, and implementing evidence-based interventions that support older adults with serious mental illness.
Publication ID: PEP21-06-05-001
Publication Date: November 2021
Format: Guidelines or Manual
2021 Mood Disorder Survey
On August 24 2021, the National Alliance on Mental Illness published findings from the 2021 Mood Disorder Survey, coordinated by The Harris Poll.
Overall, the Survey finds treatment costs and stigma are major barriers to accessing care for mood disorders. To access the full news release, go to:
https://www.nami.org/Press-Media/Press-Releases/2021/Survey-Finds-Treatment-Cost-and-Stigma-Are-Major-Barriers-to-Accessing-Care-for-Mood-Disorders
To access key findings from the Survey and the full report, go to:
https://www.nami.org/Support-Education/Publications-Reports/Survey-Reports/2021-Mood-Disorder-Survey
The Importance of Screening for Brain Injury in Older Adults: Case Studies of Success
On May 25, 2021, the National Council on Aging hosted a webinar entitled:
”The Importance of Screening for Brain Injury in Older Adults: Case Studies of Success”
Older adults have the highest rates of traumatic brain injury (TBI) – related hospitalizations, with a leading cause being from falls. Recognizing this connection, the Older Americans Act Reauthorization of 2020 allows States to use Older Americans Act funding for TBI screenings. This webinar provides an overview of the magnitude of the connection between older adult falls and brain injury, and provides stories from two states who have trained aging professionals on screening protocols.
Presenters:
- Rebeccah Wolfkiel, MPP, Executive Director, National Association of State Head Injury Administrators (NASHIA)
- Monica A. Lichi, MS, MBA, CCRP, Director, Ohio Brain Injury Program, Director, Ohio Valley Center for Brain Injury Prevention & Rehabilitation, College of Medicine Department of Physical Medicine & Rehabilitation
- Gabriela Lawrence-Soto, Grant – Project Manager, Massachusetts Rehabilitation Commission, Community Based Services Department, Statewide Head Injury Program
Please visit the link here to access the webinar recording and slide deck.
Caring for an Aging Nation
The Kaiser Family Foundation has issued a report entitled, Caring for an Aging Nation.
The report includes a series of infographics on aging issues.
Download a copy of the report here.
Or you can also access the report at. https://khn.org/news/article/caring-for-an-aging-nation/
Recording of NCOA Webinar on Screening for Brain Injury in Older Adults and Illinois TBI Resources
On May 25, 2021, the National Council on Aging hosted a webinar entitled:
”The Importance of Screening for Brain Injury in Older Adults: Case Studies of Success”
synopsis: Older adults have the highest rates of traumatic brain injury (TBI) – related hospitalizations, with a leading cause being from falls. Recognizing this connection, the Older Americans Act Reauthorization of 2020 allows States to use Older Americans Act funding for TBI screenings. This webinar provides an overview of the magnitude of the connection between older adult falls and brain injury, and provides stories from two states who have trained aging professionals on screening protocols.
Presenters:
- Rebeccah Wolfkiel, MPP, Executive Director, National Association of State Head Injury Administrators (NASHIA)
- Monica A. Lichi, MS, MBA, CCRP, Director, Ohio Brain Injury Program, Director, Ohio Valley Center for Brain Injury Prevention & Rehabilitation, College of Medicine Department of Physical Medicine & Rehabilitation
- Gabriela Lawrence-Soto, Grant – Project Manager, Massachusetts Rehabilitation Commission, Community Based Services Department, Statewide Head Injury Program
Please visit the link here to access the webinar recording and slide deck.
We thank NCOA’s Center for Healthy Aging for sharing this information with us.
SAMHSA Resources
SAMHSA now has a landing page for our resources for older adults.
CMS has recently notified and reminded beneficiaries and providers that Medicare covers mental health preventive services, including the initial preventive physical examination, annual wellness visit, and depression screening. CMS suggested that during Mental Health Month, that providers talk to their patients about their emotional, psychological, and social well-being – and that patients pay nothing if providers accept assignment.
More information can be found at:
- Medicare Wellness Visits educational tool
- Medicare Preventive Services educational tool
- Preventive Services webpage
- CDC Mental Health webpage
- Information for patients on “Welcome to Medicare” preventive visit, yearly “Wellness” visits, and depression screenings
COVID-19
- Increased Access to Mental Health Care for Older Adults: Getting Support during COVID-19
Source: Suicide Prevention Resource Center - Reducing Loneliness and Social Isolation among Older Adults
Source: Suicide Prevention Resource Center - How to Introduce Seniors to Video Chatting to Combat Loneliness
Source: Family Matters Blog - A recent national poll by the University of Michigan found that one in five adults aged 50 to 80 said their overall mental health worsened during the Covid-19 pandemic, and an equal percentage saw their sleep suffer during this period. More than one in four said they are more anxious or worried than before the COVID-19 era. To learn more and read the results of the poll, click here.
- Older Adults and the Mental Health Effects of COVID-19 (Journal of the American Medical Association, JAMA Network)
- COVID-19 Survival Guide | January 6, 2021, the Chicago Tribune published a report by Darcell Rockett that Abigail Hardin, a Rush University Medical Group rehabilitation psychologist who counsels patients from intensive care to rehab, drew on her professional experiences to write “The COVID-19 Survival Guide: How to Prepare for, Manage, and Overcome a Coronavirus Infection.” The book offers readers advice on how to navigate the virus from diagnosis to recovery. To read this guide, please click here.
Anxiety
- Anxiety in Older Adults (Mental Health America, MHA)
- Anxiety and Older Adults: Overcoming Fear and Worry (Geriatric Mental Health Foundation)
- Coping with Stress and Anxiety (American Psychological Association, APA)
Cognitive Aging
- Cognitive Aging: Progress in Understanding and Opportunities for Action (NASEM)
- Cognitive Aging (APA)
- Cognitive Health Resources (NIA)
- Healthy Brain Initiative (CDC)
Crisis Response
- Enlisting Mental Health Workers, Not Cops, in Mobile Crisis Response
CAHOOTS, a thirty-year-old Oregon program, has reduced calls to police and saved money. Now it’s going national.
By Rob Waters
Published by HealthAffairs, June, 2021 - In Mental Health Crises, a 911 Call Now Brings a Mixed Team of Helpers – and Maybe No Cops
By Katheryn Houghton
Published by Kaiser Health News, June 14, 2021
Diversity
- Language Guidelines (National Association of State Mental Health Program Directors, NASMHPD Older Persons Division)
- LGBT Older Adults and Health Disparities (SAGE)
- Multicultural Aging (APA)
- National Resource Center on LGBT Aging
- Standards and Indicators for Cultural Competence in Social Work Practice (National Association of Social Workers, NASW)
- What to Know (Diverse Elders Coalition)
Dementia
- Alzheimer’s Disease and Related Dementias (NIA)
- Alzheimer’s Disease Facts and Figures (Alzheimer’s Association)
- National Alzheimer’s Project Act (NAPA)
- National Alzheimer’s and Dementia Resource Center (AoA/ACL)
Depression
- Depression in Older Adults: More Facts (Mental Health America)
- Treatment of Depression in Older Adults Evidence-Based Practices Kit (SAMHSA)
Elder Abuse
- National Center on Elder Abuse
- Elder Abuse Facts (National Council on Aging)
- Elder Abuse and Neglect: In Search of Solutions (APA)
Family Caregiving
- How to Care for a Parent with Dementia
By Mark Stevens
Published in the Art of Healthy Living, June 10, 2021 - Caregiver Briefcase for Professionals (APA)
- Circle of Care: A Guidebook for Mental Health Caregivers (National Alliance for Caregiving, NAC)
- Connecting with Caregivers (APA)
- Resources for Professionals (NAC)
- Standards for Social Work Practice with Family Caregivers of Older Adults (NASW)
- VA Caregiver Support (U.S. Dept. of Veteran Affairs)
- How to Care for a Parent with Dementia
By Mark Stevens
Published in the Art of Healthy Living, June 10, 2021
General Mental and Behavioral Health
- Aging Well: Wellness and Psychosocial Treatment for the Emotional and Cognitive Challenges of Aging (Mental Health America)
- Good Mental Health is Ageless (SAMHSA)
- Meeting the Mental Health Challenges of the Elder-Boom (Vibrant Health)
- Mental Health First Aid: Older Adults (National Council for Behavioral Health)
- Older Americans Behavioral Health: Issue Brief Series (NCOA)
- Older Americans Behavioral Health: Webinar Series (NCOA)
- The State of Mental Health and Aging in America (CDC)
- What Mental Health Providers Should Know About Working with Older Adults (APA)
Integrated Health Care
- Older Adults (SAMHSA-HRSA Center for Integrated Health Solutions)
Medicare
- The Cost of Waiting to Act on Medicare’s Hospital Insurance Trust Fund
By Kevin Wu, Shai Akabas, G. William Hoagland, and Marilyn Werber Serafini
A Report published by the Bipartisan Policy Center, June 17, 2021 - Medicare the Health Care Delivery System – Report to Congress
Published by the Medicare Payment Advisory Commission, June 15, 2021 - Medicare Coverage of Mental Health and Substance Abuse Services (Center for Medicare Advocacy)
- Medicare and Your Mental Health Benefits (CMS)
- Toolkit for Advocates of Dually Eligible Older Adults (Eldercare Workforce Alliance)
Evidence-Based Practices/Model Programs
- Behavioral Health Programs for Older Adults (National Council on Aging)
- Building Relationships Between Mental Health and Aging Services (NASMHPD-webinar)
- Caregiver Intervention Database (Rosalynn Carter Institute for Caregiving)
- Healthy IDEAS and PEARLS: evidence-based community programs for depression identification and management (NCOA)
- Improving the Health of Older Adults by Integrating Behavioral Health into Primary Care (NASMHPD-webinar)
- Evidence-Based Practices Resource Center (SAMHSA)
- Older Adults Peer Support: Finding a Source for Funding (NASMHPD)
Public Policy
- Bipartisan, bicameral Cassidy, Fitzpatrick bill helps states enforce mental health parity law
Published by the Ripon Advance News Service, June 16, 2021
Serious Mental Illness
Substance Abuse
- Alcohol Anonymous- Alcoholics Resource Center
- Get Connected! Toolkit: Linking Older Adults with Medication, Alcohol and Mental Health Resources (SAMHSA, AoA, NCoA)
- Older Americans Behavioral Health Issue Brief Series (SAMHSA, AoA/ACL, NCoA)
- Prevention and Management of Alcohol Problems in Older Adults (NCoA)
- Promoting Older Adult Health: Aging Network Partnerships to Address Medication, Alcohol and Mental Health Problems (SAMHSA, AoA and NCOA)
- The Opioid Public Health Emergency and Older Adults (ACL)
- Improving Opioid Misuse Prevention Literacy Between Older Adults and Health Care Providers (SAMHSA)
- Substance Abuse Among Older Adults: Treatment Improvement Protocol (TIP) Series 26 – other TIP sheets available (SAMHSA)
Suicide Prevention
- Suicide and Serious Mental Illness – An Overview of Considerations, Assessment, and Safety Planning
Published by SMI Adviser and Co-presented by the Suicide Prevention Resource Center - Issue Brief 4: Preventing Suicide in Older Adults (NCOA)
- Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Centers (SAMHSA)
- Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Living Communities (SAMHSA)
- Suicide Among Older Adults (NASMHPD webinar)
- Suicide Prevention in Later Life: Connecting and Contributing (NASMHPD-webinar)
- Weaving a Community Safety Net to Prevent Older Adult Suicide (NASMHPD)
Trauma
- Disaster Preparedness Guide for Elders (Florida Dept of Elder Affairs)
- Older Adults and Disasters: How to Be Prepared and Assist Others (APA)
- Psychosocial Issues for Older Adults in Disasters (SAMHSA/CMHS Publication)
- PTSD and Older Veterans (VA National Center for PTSD)
- Trauma, Hoarding, and Home Safety: Person-Centered, Trauma-Informed Interventions for Older Adults Webinar (Jewish Federations of North America Center for Advancing Holocaust Survivor Care)
- Outreach and Service Provision to Holocaust Survivors (ACL/AoA)
- Trauma-informed care with older adults (University of Maine Center on Aging)
- Trauma-informed Care in Behavioral Health Services – Treatment Improvement Protocol (TIP 57) (DHS/SAMHSA/Center for Substance Abuse Treatment)
- Trauma-Informed Organizational Change Manual (University of Buffalo Center for Social Research)
Veterans
- Community Providers Toolkit on Behavioral Health and Wellness (VA Mental Health)
- Military Culture: Core Competencies for Healthcare Professionals (VA)
- Post-Traumatic Stress Disorder (PTSD) Consultation Program (VA)
- Older Veteran Behavioral Health Resource Inventory (VA)
Workforce
- Identifying Systems-Level Factors that Influence Workforce Capacity and Effectiveness
Published by the National Council for Mental Wellbeing, January, 2021
Project Team: Nicole Cadovius, Shannon Mace, and Courtney Brown - The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands (NASEM)
- The Impact of the Older Adult Mental Health Workforce Shortage on the Public Mental Health System (NASMHPD)
Useful Information for State and Local Mental Health and Aging Coalitions
Other Resources