Issue 1: Identify Mental Health Needs Of Geriatric Population
Goal: Determine the mental health needs of the geriatric population, including aspects of prevention and intervention.
Alaska is on the brink of significant sociologic, economic, and public health change related to the rapidly increasing proportion of older people in the population. The conservative projection suggests a doubling of the number of persons over 65 between 1990 and 2015 (up to 42,000), and the extreme projection suggests the number could go as high as 100,000 in the same time period. In either case, Alaska's senior population growth is among the highest in the country. Why this is so is less important than how our public and private systems respond to its impact.
While most seniors adapt to and capably manage the changes in their lives, inevitable losses associated with advancing age will require many of them (and their families) to call upon a wide variety of services for assistance. Not the least among these services is mental health care. The incidence of certain kinds of mental, emotional and behavioral problems among persons over 60 years of age is at least as great, and in some categories (e.g., depression, anxiety, suicide risk, dementia) much higher than in the population as large. Depression among the elderly significantly increases overall health care costs. Nationally, suicide rates among those over 65 are the highest in the country and rising. Worldwide, elderly mental illness rates are triple those for middle-aged people. Nothing suggests Alaskan immunity to these trends.
The risk factors for mental illness are clear for all to see:
· Loss of income, meaningful activity, and social status through retirement.
· Development of chronic health and perceptual problems.
· Compounded bereavement at the deaths of friends and significant others.
· Loss of mobility and increased social isolation.
· Increased risk for relocation or displacement.
While all these could happen to an individual at any stage of life, the increasing frequency with which they occur after age 60 requires seniors to be as mentally and emotionally fit as can be to avoid over-dependence on others, and to maintain a sense of personal meaning and well-being to the end of life.
Because so many more people now choose to remain in Alaska after retirement than previously, and because many more are choosing to move here in later life, it is time that systematic determination of needs and services is commenced in the area of mental health. The past decade has seen the development of an infrastructure, primarily in the urban areas of Alaska, that provides for many of the essential services older people tend to require (e.g., transportation, nutrition, primary health care, caregiver support). The mental health needs of Alaska's seniors, however, have not been addressed, with the exception of Alzheimer's Disease and related dementias. Demographic trends no longer allow Alaska to ignore senior mental health. We are all aging, and thus have a vested interest in a state with a vision to know its people and their needs, no matter their age.
312. Identify and assess specific mental health needs of the geriatric population and current status of services to that population.
313. Identify specific groups who are at higher risk of mental health problems (e.g., caregivers, homebound).
314. Collect specific data (including determining specific indicators such as suicide and substance abuse rates) to identify extent of need.
315. Determine specific housing needs, including crisis/respite and capacity to accommodate medical needs, of the geriatric population with mental health needs. Develop a plan to address housing needs that identifies potential funding resources.
316. Identify a senior mental health continuum of care, from prevention to acute and chronic care.
Responsible party (actions 1-5): Professional Services Contract (Mental Health Trust Authority Revenue) administered by Alaska Mental Health Board and Alaska Commission on Aging
317. Support ongoing research and evaluation of senior mental health needs.
Responsible party: Division of Senior Services, Alaska Mental Health Board
318. Appoint a Senior Mental Health Advisory Committee to advise and assist the Alaska Mental Health Board in geriatric mental health matters.
Responsible party: Alaska Mental Health Board