Dr. Betsy McDonel Herr Ms. Donna Wagner Dr. Rodolfo R Vega Dr. Sue Levkoff Ms. Karen Cheal Ms. Noelle Downing Positive Aging Resource Center Funded by SAMHSA Grant # SM-55043 .
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Ms. Donna Wagner
Dr. Rodolfo R Vega
Dr. Sue Levkoff
Ms. Karen Cheal
Ms. Noelle Downing
Positive Aging Resource Center
Funded by SAMHSA Grant # SM-55043
Autonomy and Physical and Mental Functioning of Underserved Older Adults: Benefits of Mental Health Care Provided Through Nine Community-Based Programs
Expansion of Local Services
Evidence Based Practice Adoption
Improve access for racial/ethnic minorities, persons in rural settings
Quality improvement activities
Public education/Health literacy
Measure GPRA outcomes
Process evaluation/Program fidelity
Simple Outcome Indicators
I. Increase existing
Prevention or delayed onset
Quality of life
Access to services
incorporated into clinical practice
Consumer/Family integration in
Increased participation by cultural/
Expanded service base
Diverse populations served
Intervention incorporated into
II. Improve quality,
Persons who are
65 years and older.
III. Build system
support expansion of services.
Cottage Program, Arizona – Donna Wagner
Health Improvement Program
for the Elderly, Arizona – Jane Singer
Tiempo de Oro, Arizona – Elizabeth Stadick
University of California, San Francisco (UCSF), Pat Areán
La Clinica Del Pueblo, Washington DC – Gloria Elliott
ElderLynk, Missouri – Rene McGovern
Senior Outreach Program, New York – Jack McIntyre
Focus Project, Texas – Gabrielle Martinez
Kajsiab House, Wisconsin – Doua Vang
Results through August 2004
During the past week, to what extent have you been experiencing difficulty in the area of: Apathy or lack of interest in things
a. No difficulty
b. A little difficulty
c. Moderate difficulty
d. Quite a bit of difficulty
e. Extreme difficulty
f. Don’t know
g. Not Applicable
Help-seeking behavior occurs in a context. For our purposes, this context is represented by the systems of care.
The organization of health services in a particular community to address the multiple health and social needs of individuals and families.
Organizational strategy to reduce fragmentation and improve collaboration.
Bringing services together to meet multiple needs of the individual through a coordinated treatment approach
Systems integration operationalized through interorganizational relations
Viewing organizations as comprised of individuals
As such, they relate to each other in a variety of ways.
For example, they refer clients to each other, coordinate services, share resources, co-locate services
Determine whether or not the components of the system of care are present in the community
If they are present, what is the relation between our grantees and the organization providing those services?
Do you make referrals to this agency?
Do you receive referrals from this agency?
Length of relation
What type of activities does your organization engage in with this agency:
What is the basis of this activity?
How frequent are your contacts or meetings with this agency/agencies?
How do you regard your level of trust and confidence in the agency?
How culturally competent do you find the agency?
Firm belief in the reliability, truth, ability, or strength of someone or something.
Source: Compact Oxford English Dictionary
Trust was positively related to the number of agencies linked to the project (r = .83, p< .02).
Trust was negatively related to the number of services provided in-house. (r = -.70, p < .08)
Trust was positively associated with six months follow-up rates (r = .84, p<.01).
Trust was positively associated with referrals to other agencies (r = .84, p<.01).
The proportion of reciprocal referrals was positively associated with:
Mental health screening (r = .87, p.<.05)
Substance abuse screening (r = .87, p<.05).
Business Development (r = .78, p < .04)
Business development was positively related to:
Sharing resources, (r = 81, p <.02)
Service providers must have access to resources or engage in certain types of interorganizational activities in order to build the necessary infrastructure to support these expanded services for meeting the diverse mental health needs of older persons, which is the core premise of this initiative.
Donna Wagner, MS GerontologyDirector, Elder ServicesCOPE Behavioral Services, Inc.Tucson, AZ
SAMHSA Grant #SM54749
Rural – Urban – Ethnic
Ready to write the story!
Outreach, Community Education
and Service Delivery
Geriatric Counseling Service (GCS)
Intercommunity Action, Inc. (INTERAC)
Promoting Older Adult Health, DHHS #(SMA) 02-3628, SAMHSA, 2002
Establish community infrastructure
Behavioral Health and Aging
Coalition of Southern Arizona
(9,659 @ 5 months/Yr3)
Average Age = 77 years old (Range 65-91)
Female 84% Male 16%
Urban 66% Rural 34%
Euro 80% Latino 20%
English 90% Spanish 10%
(Beck, Rush, Shaw & Emery, 1979; Burns, 1980)
(Laidlaw, Thompson, Dick-Siskin & Gallagher-Thompson, 2003)
(Fast & Chapin, 2000)
Sense of Mastery Scale (Pearlin & Schooler, 1978)
Physical Health Improvement
SF-12 HQ(Ware, Jr., Kosinski & Keller, 1996)
Mental Health Improvement
Geriatric Depression Scale (Yesavage et al., 1983)
Peggy – Sharon - Staci – Jolene
Unable to Treat