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University, Community Alliance to Develop Mental Health Care

Early studies show many elderly could benefit

Wednesday, May 17, 2006

The National Institute of Mental Health has awarded $2.57 million to the University of Rochester Medical Center’s Department of Psychiatry to develop a community-based system to identify and treat older adults with depression and other mental illnesses.

The five-year grant will support a unique partnership established by the Department of Psychiatry, Eldersource Care Management Services, Lifespan and Catholic Family Center that joins mental health and human services to better meet the needs of older adults.

The project is the first comprehensive effort to join social services and mental health providers to develop approaches to care for the elderly.

“A lot of mental health treatments we develop through research don’t work as well as expected when they are applied in the community,” said Yeates Conwell, M.D., professor of psychiatry and the project’s principal investigator. “Often it is because the social context is not adequately considered. Aging services providers are the experts in that area, and we in health care need to tap into their expertise. Together, we can design the best approach to care for older people with mental illness.”

The new partnership is called the Senior Health and Research Alliance, or the SHARE Alliance. Co-directors of the Alliance are: Ann Marie Cook, president and chief executive officer of Lifespan, and Irene Coveny, senior vice president for program development and services for the Catholic Family Center.

“This alliance will help innumerable older adults get the help they need to overcome depression and other mental health problems,” Cook said.

Coveny said a large number of the elderly served in Catholic Family Center programs have untreated depression.

"Through this partnership we hope to develop a new model of care, which will reduce late life depression and improve the quality of lives," Coveny said.

The size of the older adult population is growing rapidly in the United States. By 2040, more than 67 million people will be 65 years of age or older. One large study has estimated that almost 15 percent of people 65 and older have a diagnosable psychiatric disorder other than dementia. Many experts say the study underestimates the true prevalence of depression and other mental illnesses.

Many older adults do not seek help for clinical depression, an illness that often leads to other problems, including poor health outcomes, higher costs for health care and institutionalization. Experts report that fewer than half of older adults with clinically significant depressive symptoms who seek care from a primary care physician receive a diagnosis or treatment for their condition. This collaboration could provide a cost-effective way to help more people live independently in the community.

“It is not uncommon for an older person to feel sadness,” Conwell said. “But when the symptoms or depression interfere with one’s quality of life, it is something we can help them with.”

In the project’s first phase, The SHARE Alliance carefully will describe the people who receive Eldersource services and their mental health needs. Some of the SHARE Alliance’s early work already has shown that 25 percent or more of Eldersource clients have depression or anxiety significant enough to warrant evaluation for treatment.

In the next phase, researchers will track and measure the effects of the Eldersource services on elderly clients.

“We expect to show that when an Eldersource case manager helps someone handle an electric bill, conduct a home assessment or provide other services, the client’s mental health is improved,” Conwell said.

SHARE Alliance participants then will develop a collaborative system that utilizes the resources of aging services and mental health care providers.

“Our long-term goal is to improve the well-being of seniors in our community through an innovative combination of health and human services,” Conwell said.

Eldersource Care Management Services is a joint venture of Catholic Family Center and Lifespan. This program has served Monroe County residents since 1995 by providing a single source for information, guidance and care management services for older adults and their caregivers.

Lifespan has provided service to Rochester area older adults and caregivers for 35 years. The organization has an annual budget of more than $5 million and receives support from government, The United Way of Greater Rochester, numerous foundations, private contributors and through service fees. Lifespan assists approximately 19,000 older adults and caregivers a year.

Catholic Family Center is Rochester's largest comprehensive family service provider, helping almost 70,000 people each year regardless of their age, sex, religions affiliation or socioeconomic background. CFC operates a wide range of programs at 19 locations in Monroe and Wayne counties.

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