White Paper - New York State Office for the Aging

OFFICE OF MENTAL HEALTH
Most services are locally operated and are designed to provide care in an
ambulatory setting and assist individuals with mental illness to live successfully in their
communities. However, experience has shown that a growing number of individuals
meeting the definition of serious mental illness will receive treatment and support
through means other than the public mental health system, such as private mental health
and even primary care practitioners. OMH recognizes that growing racial and ethnic
diversity will require accessible and available home and community-based mental health
services delivered in a culturally and religiously competent manner. These services must
be of high quality, be based upon the best research available, and be shown by the
evidence to be effective across cultures. Moreover, providers of service must be held
accountable for the efficacy of the services they deliver.
OMH, has adopted strategies such as improved accountability, use of best
practices, and coordination of care which are responsive to the changing demographics.
One initiative, for example, “Winds Of Change,” is seeking to assure evidence-based
practices become the standard within the public mental health system. In addition,
through its research institutes, OMH will continue to support critical research focused on
treatment for dementia.
Cultural factors, immigration, socioeconomic status, language and literacy will
need to be considered in designing responses to the mental health needs of the elderly in
the future. OMH will seek to assure cultural competence is fully operationalized
throughout the service system with skilled staff to provide community-based services
using approaches that are shown by the evidence to be effective across cultures.
Reluctance on the part of many senior citizens to utilize traditional mental health
services will require OMH to work in concert with the county mental health departments
to consider mechanisms to increase the accessibility of mental health services in locations
where the elderly reside and spend their time, especially home and congregate living
situations. Accomplishing this goal will require review of regulations and reimbursement
methodologies, as well as focused training of providers.
Integration of mental health services with the public health system will be even
more critical. Primary care providers can become particularly helpful in prevention and
early intervention strategies in addressing the mental health needs of the elderly by
identifying which of their elderly patients may be experiencing social isolation and other
stressors which leave them vulnerable for anxiety, depression, and even suicide.
Training must be expanded, both for individuals working within the mental health
system and for those who work with the elderly in other settings. Staff competencies
must be developed in identifying the special mental health needs of the elderly, including
areas such as common medical disorders experienced by the elderly, dementia,
depression, risk and treatment for suicide, and other life issues affecting people in this
age group. In addition, culture plays a significant role in help-seeking, family
connectedness, care-taking roles, and views of health and wellness. The competency of
front line staff in recognizing and understanding the various ways cultural groups express
their distress and make use of help and supports will need to be included.
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