Senior Reach: An Evidence-Based Program Serving Older Adults Colorado’s Current Senior Population And it is Growing Faster than any Other Age Group… Behavioral Health Treatment Needs for the Older Adult Population Older Adult Behavioral Health Needs: Percentage of Older Adults at Risk: % of older adults with clinically significant anxiety % of older adults with depressive symptoms 27% % of older adults using psychoactive prescription medication (pain, sleep, anxiety medications) that have substance abuse potential: 25% % of older adults with co-occurring alcohol and depression % of older adults affected by the combination of alcohol and medication misuse % of older adults at risk of problem drinking 20% Substance Abuse and Mental Health Administration Issue Brief 2013 26% 19% 16% Jeste, Alexopoules, Bartels, et al. 1999 10 Things Retirees Won’t Tell You The Wall Street Journal September 21, 2014 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. We’re broke Retirement is more stressful than it looks We’re alone too much We’re in denial about our health problems……… …...and our health-care costs are huge We’re after your job We still get frisky We’re planning to move in with you Traveling the globe? We wish We’re scam magnets What is Senior Reach? An evidence-based program that provides behavioral health treatment, wellness and care management services who are isolated, frail, or need support A program that trains Community Partners (30,500 trained in Colorado and Kansas) on how to recognize the early warning signs of when an older adult may need assistance and where to refer A single entry point program with a 93% engagement rate A program that has partnered with doctors’ offices to screen older adults for depression and at risk substance use in order to provide follow-up services What is Senior Reach? A grassroots, community-based volunteer program that identifies older adults who may benefit from additional assistance and support A simple way to help older adults get assistance before a serious crisis develops A strong partnership between agencies that provide support services, businesses and community-minded individuals. A Senior Reach Outreach and Education Program in a Community Can: Address the changing demographics of the older adult population Help residents adapt to the changing needs of the community Educate the community about mental health and the needs of older adults Train volunteers to be the “eyes and ears” for older adults in need or those at risk Reduce stigma about mental health and aging Provide easy access to information in an elder-friendly manner. The mission of Senior Reach is to support the well-being, independence and dignity of older adults by educating the community, providing behavioral health, care management services, and connecting older adults to community resources. Senior Reach® is honored that its program is recognized as a National Evidence-Based Program through the Substance Abuse and Mental Health Services Administration's(SAMHSA) National Registry of Evidence-Based Programs and Practices (NREPP)! Collaborative Management & Partnership Arapahoe Douglas Mental Health Network : -Behavioral Health Clinicians -Management of program - Marketing & Develop. - Clinical Supervision - Fiscal Agent Community Partner Trainers: -Innovage - Love Inc. - South Metro Health Alliance - Meals on Wheels - City of Littleton - Consortium of Older Adult Wellness - Arapahoe Douglas Mental Health Network Seniors’ Resource Center: - Call Center -Data Collection Senior Reach DatabaseOutcome Measures Senior Reach Components • Senior Reach outreach and education services train individuals and professionals in the community to identify and refer seniors in need. • Other community training: suicide prevention, health care issues for seniors • Training specific to health care providers who are screening for behavioral health needs Community Education & Outreach Screening • Telephonic single point of entry: information/ community referrals are provided as needed; link to behavioral health, and wellness services • Screening at PCP offices/ health care clinics • Intake • Brief in home treatment • Referral to community resources and wellness services Services As Needed What Does a Senior Reach Community Partner Do? Community Partners are professionals and individual community members who have been trained in identifying and referring older adults in need of assistance They become keen observers of an older person’s personal appearance, mental and emotional states, personality and physical changes, poor health, social problems, substance abuse, caregiver stress, abuse or neglect, social isolation, financial hardship, and the risk factors of suicide Research Data- 14 Statistically Significant Outcomes* Including… Better overall level of functioning Increased optimism about the future Increased positive activities with others Reduction in social isolation Decreased emotional disturbance Decreased risk of suicide Better outcomes on the Geriatric Depression Scale *Indicates statistically significant change at p< .05 from time of enrollment to dischargepaired sample t-tests. Bartsch, D.A., & Rodgers, V.K. (2009). Senior Reach Outcomes in Comparison with the Spokane Gatekeeper Program. Care Management Journals, 3(10), 82-88. Senior Reach: A Solution for Communities Proven population- based, health intervention that focuses on prevention Proven to reduce fragmentation & better utilization of community resources Proven 93 % engagement rate & clinical outcomes Proven to reduce suicide risk. Seniors represent 13% of the population yet account for almost 15.7% of suicides Proven high customer experience/ satisfaction. 94 % would recommend Senior Reach to someone else Senior Reach has been approved for inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP). Senior Reach, Braided and Blended Funding Senior Reach bills Medicare, Medicare-Medicaid, private insurance, and Capitated Medicaid for all behavioral health services Our local Area Agency on Aging provides funding for behavioral health services for those who are uninsured Senior Reach has been extremely successful in receiving grant and foundation funding. To date, the program has received over $2.3 million! Funding for positions is shared across three sites and existing staff can be used Boulder has been successful in using tax dollars to support a clinical position (sales tax initiative) Expanding Our Impact… In the counties served by JCMH and MHP, Senior Reach has provided integrated care in multiple primary care practices. Over 4,000 older adults have been screened within12 months and over 637 brief interventions have been provided for depression and at-risk substance use. 29% of those screened were positive for depression and 11% were positive for at risk alcohol, substance, prescription misuse. What we’re learning: - screening in PCP offices is effective for early detection and case finding for older adults - effective referral protocol and care coordination Colorado Senior Reach Outreach and Education Program Arapahoe/Douglas Mental Health Network and Partners From July 1st through September 30th there have been 14 Community Partner Trainings. 22 Trainers were trained 217 individuals in the community have been trained. We have brought on a volunteer Patient Navigator who will be able to support the clinical team, and provide some administrative support to Senior Reach. Future plans include adding Wellness programming and expanding senior peer programming Senior Reach Remains a Vital Part of our Community Because… By 2020, the 60+ population will have more than doubled Some seniors have little or no support from family and friends Seniors often face multiple challenges that can be effectively addressed by Senior Reach Senior Reach fills a critical gap in services and is able to provide assistance before a crisis develops THANK YOU! Barbara Becker, Ph.D. Director, Community Programs Arapahoe/Douglas Mental Health Network bbecker@admhn.org Please Visit Our Website For more information, please visit, www.seniorreach.org 25