Meeting the Mental Health Needs of Older Adults in NYC
By: Michael B. Friedman
Good morning. My name is Michael Friedman, and I am the Chairperson of The
Geriatric Mental Health Alliance of New York - an advocacy group formed by the Center for Policy, Advocacy and Education of the Mental Health Association of New York City in January 2004 to confront the mental health challenges of the elder boom and to promote critical changes in policy and practice. The Alliance currently has over 2000 members. We have workgroups on policy and advocacy in NYC and Albany. We have also formed specialty workgroups on the mental health needs of minority elders, people with serious and persistent mental illness who are aging, and people in long-term care.
We also sponsor a series of presentations on best practices with national experts, have co-sponsored numerous conferences, and provide technical assistance regarding service models and funding.
As you know, over the next 25 years the number of older adults in NYC will increase 60%—from 900,000 to 1.5 million. This will result in a rise in the numbers of older people with mental disorders—from 180,000 now to 300,000 in 2030. Our helping systems cannot meet the needs of the current population. (We estimate that at most 25% of older adults with mental illnesses get mental health services.) It is easy, and sad, to imagine how much the unmet need will grow if services do not increase at least at the pace of population growth.
But this is not just a matter of numbers. Fundamental changes are needed to:
? Help older adults remain in the community and avoid institutionalization
? Increase access to community-based services
? Improve the quality of services
? Integrate mental health, health, and aging services
? Increase the capacity of the system to serve cultural minorities
? Provide support for family caregivers
? Reach out to elders and their families and provide education to overcome stigma, ageism and ignorance
? Build a workforce that is clinically and culturally competent and large enough to meet the growing need.
Because many older adults will not, or cannot, go to a mental health treatment setting, one absolutely key element of adequate service will be the ability to serve older adults where they are: in their homes, in their apartment houses, in their senior centers, in their NORC-SSP programs, in their social adult day programs, in their houses of worship—in all the places where seniors have trusting relationships and go to for help
Such home and community based services clearly offer a great opportunity to address the needs of older adults with mental disorders. They offer opportunities for inhome counseling. They offer opportunities for screening and early identification. They offer opportunities to provide social involvement and activities, which are essential to maintaining mental health. And they offer opportunities to provide on-site counseling and treatment for older adults with mental disorders.
Unfortunately it is very difficult to provide home and community based services because there is very little funding to do so. That is why we are here today—to urge you to once again provide funding for the Geriatric Mental Health Initiative and to increase that funding to $3 million.
We also urge you to do what you can to add this funding to NYC’s base budget.
As it is, providers have not assurance of funding from year to year, and this can complicate start up and continuity of care. We understand that that is a Mayoral decision, but we would vastly appreciate whatever the Council can do so that this funding is predictably available from now on.
It is clear to us that providing mental health services in the home and in community based settings would vastly increase the numbers of older adults who are able to get the professional mental health services they need so that they can live and age well in the community.
But we believe it is also important to address the need for workforce development. We urge the Council to provide, in addition to $3 million for services, $200,000 for training initiatives designed to cultivate the clinically and culturally competent workforce we will increasingly need as time goes on.
We thank you for the opportunity to speak today. Please feel free to call on us at any time for background information about geriatric mental health.