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ADDRESSING MENTAL HEALTH INSSUES IN OLDER VETERANS. September 23, 2010 Lucille Collins Karatzas, LICSW Director, Elder Program, Seacoast Mental Health Center Director, REAP Program. THE OLDER PERSON. How old is “old” The hidden population Health and mental health connection.
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ADDRESSING MENTAL HEALTH INSSUES IN OLDER VETERANS September 23, 2010 Lucille Collins Karatzas, LICSW Director, Elder Program, Seacoast Mental Health Center Director, REAP Program
THE OLDER PERSON • How old is “old” • The hidden population • Health and mental health connection
Aging Process Very brief overview • Vision • Hearing • Stability • Sensory • Cognition • Reaction Time • Self Image • All of these are amplified under stress
MENTAL HEALTH ISSUES and THE OLDER VETERAN The same as for any group but with varying intensity and other complications • Depression • Anxiety • Grief and Loss • Substance Misuse/Abuse • Bipolar disorders • Severe Mental Illness • PTSD, TBI and other combat related issues • Suicide
SOME THEORIES about increased completed suicides in elders • More frail • Live alone less likely to have someone intervene and save them • More determined so use more lethal means • 75% of elders use guns vs 55% general population
RISK FACTORS • Psychiatric Illness • Medial Illness • Psychiatric Illness • Social Isolation- Alienation • Personality Characteristics • Combination of factors increased risks
ENGAGING THE OLDER VETERAN • Expectations • Assumptions • Environment • Language, • Pace
BUILDING RESILIENCY • Decrease Isolation increase community • Developing new skills • Build on past positive coping skills
LOOKING AT THE FUTURE • Changes in roles • Importance of meaningful activities • Importance of support network • Importance of community • The role of Generativity and Integrity
NH STATEWIDE REAP PROGRAM Referral Education Assistance & Prevention • All reap services are FREE to the consumer (Blended funding) • Brief counseling(up to 5 sessions) • Educational Sessions (anywhere older adults congregate) • Community Interventions/Mediation (in housing sites or senior centers) • Technical assistance (to housing and other professionals)
AGE CRITERIA &WHERE SERVICES ARE PROVIDED • Age criteria: • The person is age 60 or older • Concerned about an elder • Or is under 60 but living in senior housing • Services can be provided in the home, senior centers, at a friend’s home, religious institutions – at the MHC if person wishes etc. • Services are not provided in Nursing Homes or assisted living facilities unless the person is transitioning out of the facility.
REAP COUNSELORS • Cover the entire state • Affiliated with each of the 10 mental health centers • Social workers, Mental Health Counselors, Psychiatric nurses, Case managers • All trained on using evidenced based practices
HELPFUL INFORMATION WHEN MAKING A REFERRAL • Meets the age criteria. • The person should know you are making a referral and agreed to see a REAP Counselor. • General idea of issues and concerns. • Safety of doing home visit has been assessed. • Directions.
MAKING A REFERRAL • Service Link : 1-866-634-9412 • Your local Mental Health Center