Medicine and Eldersource Care Management Services, Inc. (Eldersource). Eldersource is a joint venture of Monroe County's two largest non-medical aging service providers established in 1995 to provide a single access point for obtaining information, guidance, and care management (CM) services for older adults and their caregivers. The partnership will be known as the Senior Health and Research (SHARE) Alliance. Social factors are integral to the pathogenesis, course, and outcome of late life mental disorders. Our premise is that a partnership of the social and mental health services networks will enable development of novel and effective approaches to the detection, treatment, and prevention of mental illness in seniors. The SHARE Alliance will constitute an infrastructure for research that is responsive to both social and health needs of this underserved segment of the community's seniors. Based on community and Eldersource needs assessments, our preliminary focus will be on affective disorders in it clients. The SHARE Alliance will make aging services a central component and principal partner in the study and delivery of care to community dwelling older adults with mental illness. SHARE Alliance objectives relate to partnership development and research. The partnership must be replicable. Therefore, we will develop, evaluate, and document its activities and processes using an established framework for organizational development and management of healthcare and non-profit organizations. Research objectives include modification of data bases and associated procedures to enable the collection and linkage of research data with the individual, electronic client records maintained by the aging services network;training of staff in their reliable use, and the conduct of three preliminary research studies. Study 1 aims to establish the prevalence and the demographic, physical, social, and clinical correlates of affective disorders in elderly clients who seek Eldersource services. Study 2 will follow subjects with clinically significant mood disorders longitudinally to determine the nature of and responsiveness to CM """"""""care as usual"""""""" (CM-CAU). These preliminary data will be used to inform the development and testing in Study 3 of an integrated depression care management (Dep-CM) protocol modeled on the MacArthur Initiative on Depression in Primary Care and adapted for use by a collaborative aging services and mental health team. The SHARE Alliance infrastructure and preliminary data from these studies will result in applications for additional extramural funding (R34, R01, foundation grants and a demonstration project) to further develop and disseminate the model.
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