Nearly 140 participants from around the state gathered in September to discuss how to improve access to mental health and substance abuse disorder services for older adults.
The Pennsylvania Association of Area Agencies on Aging (P4A) convened the statewide Older Adult Behavioral Health Strategic Planning Summit on Sept. 15 and 16 with member Area Agencies on Aging (AAAs) and other essential stakeholders at the Kalahari Resorts in the Poconos.
“The biggest thing we took away is that we have a lot of work to do,” said Lynn Cooper, the behavioral health specialist for the Pennsylvania Association of Area Agencies on Aging. “I was also impressed with the degree of passion and enthusiasm to address these issues. There was tremendous energy, passionate discussion and excellent ideas regarding actions needed to improve access to these vital services to older adults.”
The overarching goals of the summit were to identify the impact, unmet needs, and significant challenges associated with access to care for older adults with mental health and substance use disorder in Pennsylvania; identify specific short-term and long-term goals and priorities for addressing these needs in Pennsylvania; and identify actionable steps leveraging cross-agency and cross-sector collaborations, capabilities, and capacities, according to a report from P4A.
There was significant consensus on the barriers among the attendees allowing for several themes to emerge from the group sessions, according to P4A.
“The barriers reached across a range of issues,” according to P4A. “They included insurance and payment issues (especially Medicare), coordination and communication challenges between systems, the need for cross-training, insufficient numbers of staff and untrained staff, and inadequate treatment networks, especially for long-term treatment placements. The participants emphasized that older adults with basic material needs such as housing, transportation, and food insecurity must be addressed as well in coordinating mental health and substance use disorder issues.”
There was also “recognition for the need for equity in solutions for all older adults, not just those who are dually eligible with access to Medicaid, for example, those with Medicare only. There is a distinct need for awareness of generational/aging cultural competence to reduce biases and discrimination,” according to P4A.
A central theme was identified by participants throughout the summit: the need to incorporate input from older adults with lived experiences and build a robust Peer Support system for older adults. The group also emphasized family members’ central role and added considerable insights into this population’s needs, according to P4A.
Some prioritized immediate and short-term strategies were identified and could be implemented over the next year, including initiating training; issuing bulletins or announcements in other relevant state agencies, emphasizing the unique needs of older adults and a commitment to behavioral health services for older adults, convene local system partners to collaborate; and identify cross-training opportunities, and develop local priorities using the E4 Center Cross Sector Tool Kit. Consider including; AAAs, crisis, county mental health and substance use disorder, treatment providers, hospitals, law enforcement, housing, and EMS, according to P4A.
Other short-term strategies include improving access to data regarding the number of older adults screened, referrals made, and services provided; doing a statewide inventory of the mental health and substance use disorder systems to determine the behavioral health treatment services available for older adults; doing an inventory of the bed capacity for acute inpatient psychiatric treatment for older adults; and expanding Healthy IDEAS (Identifying Depression & Empowering Activities for Seniors) in the Area Agencies on Aging where possible, according to P4A.
Further short-term strategies include expanding and funding screening, brief intervention, and referral to treatment (SBIRT) at Area Agencies on Aging where possible; researching and circulating mental health and substance use grant opportunities (public and private) to develop local systems and services, especially crisis services designed to address the unique needs of older adults; establishing and circulating resources; developing a state best practice guide for older adults and behavioral health; and encouraging partners to connect with local universities and provide education on working in aging and behavioral health to recent graduates, according to P4A.
Brenda Appel, the deputy director of the Columbia-Montour Aging Office Inc., attended the conference.
“We are headed in the right direction but need to continue to push forward to ensure our older adults are receiving appropriate care,” said Appel.