Completed by the Advisory Committee on Geriatric Services, a legislatively mandated committee of the Illinois Department of Human Services, Office of Mental Health, in cooperation with the Illinois Department on Aging. September 1997. The 21 member Advisory Committee on Geriatric Services is a legislatively mandated committee of the Illinois Department of Human Services (DHS) in cooperation with the Illinois Department on Aging (IDOA). A geriatric needs assessment survey was conducted by this Advisory Committee of funded DHS and IDOA community agencies regarding the services offered by each to the elderly. There were two similar surveys, each customized for either the DHS or IDOA funded group of agencies to assure that the agencies understood the terminology and reference points for their responses. The DHS survey was sent to 153 mental health agencies and the IDOA survey to 85 agencies serving the elderly. The response rate for the DHS survey was 59% (90 agencies) and 74% (63) of the IDOA agencies. The community agencies that received the surveys used various techniques to provide the information requested since each discipline has different data collection systems and different approaches for assessing need. In both surveys, the community agencies were allowed to provide multiple responses to questions. Percentages in the report are based on the number of responses and do not correlate to client counts (there was no attempt to identify unduplicated counts in the survey) and multiple mental health diagnosis. The Advisory Committee has not yet identified the areas of the state that may be over or under represented in the return of the surveys or their results; there are no rural, suburban, or metropolitan comparisons; nor did the Committee compare results from IDOA agencies to DHS agencies serving the same territories. The report does provide information on a number of needs and issues that are common to both sets of agencies. The Mental Health Survey responses were concentrated from not-for-profit mental health agencies (86% not-for-profit agencies) who were single purpose agencies (82%). The range of service recipients identified in the Mental Health Survey were 0 to 1,003. The total number of geriatric patients reported from all surveys were 9,067. The Aging Survey responses similarly were from not-for-profit agencies (82.3%). 65% were multi-purpose senior service centers. The numbers of clients served ranged from 6 to 8,300, with a total from all surveys numbering 92,572 clients (this is total number of seniors served, not the number categorized with mental health concerns). 51% of the Aging agencies reported that they encounter mental health needs from clientele either daily or weekly. The Aging and Mental Health diagnostic categories for current open cases were reported as follows:
The symptoms identified most frequently were:
The results tend to demonstrate overall consistency of needs. Where Aging respondents also operate an elder abuse and neglect program, responses are higher on questions related to victimization, exploitation, and mismanagement of finances. Where mental health agencies work with more difficult and complex mental health issues, there tends to be a more complicated or sophisticated identification of a problem, such as inappropriate social behavior, delusions, etc. Mental health agencies stated that 90% of those identified with a diagnosis, symptoms, and/or problem behaviors received its services while Aging reported 83% of these individuals received its services. With a few exceptions, the types of services provided by each discipline were different. Both mental health and Aging agencies reported assessment as the top service provided. The other services both disciplines identified as provided were case management and medication monitoring. Mental health agencies reported the following as their top services used for their clientele with a diagnosis, symptoms, and/or problem behaviors:
Aging agencies reported the following as their top services used for their clientele with a diagnosis, symptoms, and/or problem behaviors:
Barriers to the provision of mental health services included the stigma associated with the use of mental health services and the lack of services available to the homebound persons. When clients did not receive services, the following reasons were presented:
Referrals for service were received from a variety of sources including:
Mental health agencies identified home visits, outreach, and supportive case management as effective in working with the elderly population. Specific treatment approaches suggested were reminiscence techniques, reality based problems solving, and cognitive-behavioral approaches, bio-psychological techniques, and psychosocial treatment. Mental health agencies made referrals to meals on wheels (36.7%), adult day services (27.8%), senior meal sites (12%), homemaker services (11%), visiting nurses services (10%), elder abuse programs (8.9%), case management agencies (7.8%), and local health departments. A total of 79.4% of Aging’s agencies made referrals to mental health agencies, but only 54% of its case management agencies made such referrals. Coordination efforts by mental health agencies concentrated on the DHS local area network and establishing a working relationship with the local case management agency. Three quarters of the case management agencies reported they had not participated in a mental health local area network. Mental health agencies suggested the following training needs for staff providing services to older adults;
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