(provided by the PI): The use of evidence-based mental health services by persons over the age of 65 is the lowest among all population groups. The purpose of this demonstration project is to establish the evidence based Collaborative Model of Mental Health Care for Older Iowans in three rural locations where a community mental health center partners with a primary health care clinic. With the support of an AHRQ R18 Research Demonstration award, we will meet three specific aims: (1) organize the clinical and administrative infrastructure necessary for successful implementation of the model within each site;(2) deliver clinical services that are evidence-based, and meet performance and financing expectations;and (3) establish a model of care that is clinically effective, financially sustainable, and can be expanded to serve a greater number of older individuals. Altogether, over the proposed three year demonstration period, the sites will have screened a total of more than 1,620 older Iowans, completed a formal diagnostic assessment on 324 of these individuals, and conducted a six month course of treatment for 162 older Iowans who are diagnosed with a common psychiatric disorder such as anxiety, depression, dementia, or substance misuse. The Collaborative Model was created with the support of the Iowa Department of Human Services and the National Institute of Mental Health, and the project team members are unmatched. They consist of leaders and experts from across the state of Iowa, highly motivated clinical and administrative staff from three sites, and nationally recognized consultants who have established a successful track record of working together during the past four years. Our application is innovative because this is the first time an evidence-based model of collaborative care would be translated into rural community settings where there is a growing population of older adults and a lack of qualified mental health service providers and targeted programs. The Collaborative Model also allows for more mental health problems to be identified and treated, facilitates flexibility in staffing and other site specific operations, requires formal diagnostic assessments, and a treatment plan that goes well beyond symptom- specific, time-limited approaches. The project is significant because it addresses a prominent public health problem concerning the lack of access to and use of specialty mental health services among the fastest growing segment of the American population. This demonstration will provide an example for other rural states that face similar challenges in terms of a shrinking mental health workforce, a lack of targeted programs for older adults, and growing population of persons over 65.
Relevant to Public Health this demonstration project addresses a prominent problem concerning the lack of access to and use of specialty mental health services by older adults. This is the first time an evidence-based model of collaborative care targeting older adults with mental illnesses would be translated into primary health care clinics located in rural communities. This work is most relevant to those state and local jurisdictions that face a booming population of older adults and a substantial lack of qualified mental health service providers and targeted programs.