Tuesday, August 26, 2008

Geriatric Mental Health Alliance News - Week of August 18, 2008

Geriatric Mental Health Alliance News
A bi-weekly email to brief you on issues important to geriatric mental health

August 18, 2008 - Vol 2, Issue 10


Sad NYS Budget News


As many of you know, Governor Paterson and the legislature have agreed to over $400 million in cuts to the 2008-9 budget and over $600 million in 2009-10.

The budget cuts include:
  • 6% across the board cut to unspent local assistance
  • 50% reduction to new and enhanced executive programs in the 2008-9 enacted budget
  • 6% cut to new and enhanced legislative programs
  • $50 million cut to executive and legislative members items
  • 7% reduction in support of City University of New York (CUNY)
  • $50 million is savings from general funds transfer (includes delay of statewide wireless network)
  • $127 million in Medicaid and other health care savings

The 6% cut to local assistance includes mental health and substance abuse programs that serve older adults.

We do not yet know the full impact these cuts will have on geriatric mental health and substance abuse programs, but we will provide updates as we get new information.

Given the future budget cuts, it's going to be a difficult upcoming budget cycle for geriatric mental health. We hope you will join us in our advocacy efforts to preserve critical services for elders with mental disorders and to take advantage of regulatory and financial restructuring opportunities to ensure the inclusion of geriatric mental health.


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Congratulations Kim!

We are very pleased to announce that Kim Steinhagen, Director of the Alliance married Daniel Williams on August 2nd. She is now Kimberly A. Williams. Please note that her email has changed from steinhagenk@mhaofnyc.org to kwilliams@mhaofnyc.org. Phone number and address will remain the same.


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Update regarding Antipsychotic Medications


In our last newsletter, we reported on an article in Science Update reporting that Antipsychotic Medications May Ease Some Alzheimer's Symptoms, Not Others. Eileen McGinn, MPH, an alliance member, has pointed out an absent fact.


This article fails to note that these drugs are NOT approved for the treatment of dementia. Further, they have a black box warning for a 60-70% INCREASED rate of mortality when used off-label for dementia. Even the TV ads note that important fact.

Informed decision making requires complete and accurate information. Failure to provide complete and accurate information about treatment results in increased adverse events, costs and suffering, and in the case of off-label use of this class of drugs, increased rates of death.

Ms. McGinn has also updated us with the fact that in June 2008, the FDA updated their notification to healthcare professionals that both conventional and atypical antipsychotics are associated with an increased risk of mortality in elderly patients treated for dementia-related psychosis.

In April 2005, FDA notified healthcare professionals that patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death. Since issuing that notification, FDA has reviewed additional information that indicates the risk is also associated with conventional antipsychotics.

Antipsychotics are not indicated for the treatment of dementia-related psychosis.

Click here for more information.

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Upcoming Events

**NOTE**
CANCELLED - The Paradoxes of Aging: Psychotherapy with Older Adults
conference sponsored by the Met Chapter of the New York State Society for Clinical Social Work scheduled for September 13, 2008 has been CANCELLED.

September 11, 2008 - Making Every Day Count: A Challenge for Geriatric Care Managers. An annual conference of the Greater New York Chapter of Professional Geriatric Care Managers. The keynote will be by David Spiegel, MD, Director of the Center on Stress and Health, Stanford University School of Medicine and Rona Bartelstone, LCSW, Founder and past President of NAPGCM. The event will be held at the Roosevelt Hotel, 45th & Madison Ave. from 08:30am - 04:30pm.

September 15-17, 2008 - Successful Solutions & Collaborative Outcomes sponsored by NYSRA. The topics and workshops offered at this Leadership Training Summit is geared to give attendees the opportunity to hear leading experts on both the national and state level on topics pertaining to leadership development, supervisory skills, best practices, and technical assistance. The event will be held at the Desmond Hotel and Conference Center, Albany.

September 18, 2008 - Cutting Edge Approaches: Sizing up the Workforce for the Elderboom. An annual conference of the New York Southern Area Aging (NY-SAAN) to educate via workshop sessions and presentations led by international and national expertise in the field of aging and workforce development. The event will be help from 8:00am - 5:00pm at The Roosevelt Hotel (45 East 45h St.). Please click here (www.NY-SAAN.org) for more information.

September 18, 2008 - Clearing the Air: The Facts About Smoking & Mental Illness. This workshop will focus on how smoking affects your life and what NYC is doing \to help you quit. The interactive presentation will provide resources and help you move towards a smoke-free life. The event will be held from 2:00pm - 4:00pm at the NYU School of Medicine, Schwartz Lecture Hall (401 E. 30th St.).

September 23, 2008 - Addressing the Needs of Nursing Home Residents in Psychological Distress: Strengthening Family/Nursing Home Partnerships: This half-day conference, being sponsored by FRIA, and targeting caregivers, family/friends of nursing home residents, professionals, nursing home administrators and staff will feature two panels made up of experts in the field of geriatrics, consumer advocates, a caregiver and a staff member of a nursing home. Kim Williams from GMHA will be presenting on one of the panels. It will take place from 8:30 a.m. - 1 p.m. at Community Church Assembly Hall, 40 East 35th St.

To reserve a seat or if you have questions please contact FRIA at 212-732-5667.

September 24-26, 2008 - NYAPRS 26th Annual Conference - Integrating Our Services: Integrating Our Lives A conference celebrating the advances in the promotion of the recovery, rehabilitation and rights of people with psychiatric disabilities, the event will be held at the Nevele Grande Hotel, Ellenville, NY.

Please click here for registration and brochure.

October 2, 2008 - Meeting the Mental Health Challenges of the Elder Boom. A community conference for Health and Human Service Providers and Family Care Givers from Warren and Washington Counties. The keynote speaker will be Michael Friedman. The conference will be held at the Queensbury Hotel from 08:00am to 12:00pm.

October 23-25, 2008 - Save-the-Date: State Society on Aging of New York 36th Annual Conference This year's theme is: Geriatric Mental Health: Practice, Research, Education, and Policy and the conference will be held at the Gideon Putnam Hotel in Saratoga Springs, NY. Michael Friedman will receive the President's Award in recognition of the work of the Geriatric Mental Health Alliance.

November 12-13, 2008 - Empowering Communities for Successful Aging. Housing, Neighborhood Supports, and Services. This conference will help provide communities with the tools to become elder friendly and more livable for persons of all ages. The conference will be held at the Saratoga Hilton and Conference Center, Saratoga Springs, NY.

November 21, 2008 - Save the Date! The Trauma and Addictions Conference sponsored by The Division of Addictions of the NYS Psychological Association. This conference will address the issue of how to treat co-occurring pathologies such as trauma and addictive disorders in an integrated and effective manner. Keynote speaker is Denise Hien, Ph.D. The event will be held from 9:00am-4:00pm at NYU Silver Building (100 Washington Square East, Room 702).

RRTI 2008-9 Geriatrics and Developmental Disabilities Nurse Training Program The Rehabilitation Research and Training Institute is pleased to announce the schedule for the 2008-2009 Geriatrics and Developmental Disabilities Nurse Training Program. For a full list of courses and their descriptions and registration, please visit www.rrti.org. Nurses with all levels of training are invited to register for these free courses. Please note that a certificate is available for those Nurses who complete C1-C4 and Nursing Contact Hours can be obtained. For more information and questions, please contact Matt Yaeger at matt@nyrehab.org or 518-449-2976 ext 101. Courses start September 17, 2008 at various videoconference sites.

This continuing education activity has been submitted to the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation

NY Connects Building Connections Workshop
NY Connects is pleased to announce the Building Connections workshop that will be offered in 6 locations across the State. This workshop is designed to support and strengthen local program operations and the Long Term Care Councils. NYSOFA Director Burgess or his designee, and a representative from DOH will provide opening remarks on the current status and future directions of long term care in NYS.

To register, please click here.

Educational Seminar Series at Service Program for Older People (SPOP) This training opportunity features SPOP clinicians who have extensive experience with older adults and mental health. It is offered to the professional geriatrics community and all who work with seniors. Each seminar is held at: 302 West 91st Street at West End Avenue, New York, NY. Seminar fee: $15. Discount for 3 or more attendees from the same organization. Space is limited. Please register in advance by mail or online at www.spop.org or call: 212-787-7120.

For topics, dates, and registration information, click here.

HIV/AIDS and Older Adults Trainings The AIDS Community Research Initiative of America (ACRIA) and the Council of Senior Centers and Services (CSCS) is offering a citywide HIV training program funded by the New York City Council. These free trainings will help senior service providers address HIV prevention issues and understand better the needs of those aging with HIV. Each seminar is held at various locations.

For dates and registration information, click here.

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36th Annual Conference of the SSANY: Sponsor

NYSSA is offering sponsorship, exhibitor & advertising opportunities for their upcoming annual conference entitled The Road to the Future: Healthy Aging & Mental Health that will take place October 23-25th at the Gideon Putnam Hotel, Saratoga Springs, NY.

To learn more about sponsorship opportunities, click here.

Friday, August 1, 2008

Geriatric Mental Health Alliance News - Week of August 4, 2008

Geriatric Mental Health Alliance News
A bi-weekly email to brief you on issues important to geriatric mental health

August 04, 2008 - Vol 2, Issue 9


Congratulations Kim!

We are very pleased to announce that Kim Steinhagen, Director of the Alliance is marrying Daniel Williams on August 2nd. When she returns from her honeymoon-in Thailand no less-she will be Kimberly A. Williams. Please note that her email will change from steinhagenk@mhaofnyc.org to kwilliams@mhaofnyc.org. Phone number and address will remain the same.

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Substance Abuse and Misuse in Older Adults

Michael and Kim recently published an article titled "Substance Abuse and Misuse in Older Adults" in Aging Well, The Magazine for Professionals Promoting Positive Aging. Discussing the warning signs specific to older adults who struggle with drug and alcohol issues.

Click
here to read more.


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NYC 9/11 Benefit Program for Mental Health & Substance Use Services

The New York City Health Department is offering an insurance-like benefit to help cover mental health and substance-use treatment for NYC residents still affected by the terrorist events of September 11, 2001. Please click here for more information or here to order materials for handout.

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Upcoming Events

September 11, 2008 -
Making Every Day Count: A Challenge for Geriatric Care Managers. An annual conference of the Greater New York Chapter of Professional Geriatric Care Managers. The keynote will be by David Spiegel, MD, Director of the Center on Stress and Health, Stanford University School of Medicine and Rona Bartelstone, LCSW, Founder and past President of NAPGCM. The event will be held at the Roosevelt Hotel, 45th & Madison Ave. from 08:30am - 04:30pm

September 13, 2008 - CANCELLED -
The Paradoxes of Aging: Psychotherapy with Older A conference sponsored by The Met Chapter of the New York State Society of Clinical Social Workers and co- sponsored by the Geriatric Mental Health Alliance and Fordham University Graduate School of Social Service. Morning Keynote will be by Gene D. Cohen, MD, Ph.D. Michael Friedman will be a discussant. The event will be held at Fordham University, Manhattan Campus (113 W. 60th St.) from 08:30am to 04:00pm. For more information, please contact SBW Partners at (212) 337-2555.

We will keep you informed on the rescheduled date.

September 24-26, 2008 - NYAPRS 26th Annual Conference - Integrating Our Services: Integrating Our Lives A conference celebrating the advances in the promotion of the recovery, rehabilitation and rights of people with psychiatric disabilities, the event will be held at the Nevele Grande Hotel, Ellenville, NY.

Please click
here for registration and brochure.

October 2, 2008 - Save-the-Date: Meeting the Mental Health Challenges of the Elder Boom, a community conference for Health and Human Service Providers and Family Care Givers from Warren and Washington Counties. The keynote speaker will be Michael Friedman. The conference will be held at the Queensbury Hotel from 08:00am to 12:00pm.

For more information, please click
here.

October 23-25, 2008 -
Save-the-Date: State Society on Aging of New York 36th Annual Conference This year's theme is: Geriatric Mental Health: Practice, Research, Education, and Policy and the conference will be held at the Gideon Putnam Hotel in Saratoga Springs, NY. Michael Friedman will receive the President's Award in recognition of the work of the Geriatric Mental Health Alliance.

November 12-13, 2008 -
Empowering Communities for Successful Aging. Housing, Neighborhood Supports, and Services. This conference will help provide communities with the tools to become elder friendly and more livable for persons of all ages. The conference will be held at the Saratoga Hilton and Conference Center, Saratoga Springs, NY.

NY Connects Building Connections Workshop
NY Connects is pleased to announce the Building Connections workshop that will be offered in 6 locations across the State. This workshop is designed to support and strengthen local program operations and the Long Term Care Councils. NYSOFA Director Burgess or his designee, and a representative from DOH will provide opening remarks on the current status and future directions of long term care in NYS.

To register, please click
here.

Educational Seminar Series at Service Program for Older People (SPOP) This training opportunity features SPOP clinicians who have extensive experience with older adults and mental health. It is offered to the professional geriatrics community and all who work with seniors. Each seminar is held at: 302 West 91st Street at West End Avenue, New York, NY. Seminar fee: $15. Discount for 3 or more attendees from the same organization. Space is limited. Please register in advance by mail or online
here or call: 212-787-7102 ext.515.

For topics, dates, and registration information, click
here.

HIV/AIDS and Older Adults Trainings The AIDS Community Research Initiative of America (ACRIA) and the Council of Senior Centers and Services (CSCS) is offering a citywide HIV training program funded by the New York City Council. These free trainings will help senior service providers address HIV prevention issues and understand better the needs of those aging with HIV. Each seminar is held at various locations.

For dates and registration information, click
here.

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Speak Out About Access to Mental Health Services

The National Alliance of Mental Illness of New York Metro is working to improve mental health insurance coverage for New Yorkers and would love to hear your story. Participate in a BRIEF, PAID, PHONE INTERVIEW regarding your mental health insurance coverage. To schedule an interview or for more information, please call Vera Oziransky at 212-684-3365 or email
insurance@naminyc.org

Click
here for more information.

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In the News…Antipsychotic Medications May Ease Some Alzheimer’s Symptoms, Not Others

Antipsychotic Medications May Ease Some Alzheimer's Symptoms, Not Others

Science Update
June 23, 2008

Antipsychotic medications may lessen symptoms like hostility and aggression in patients with Alzheimer's disease, but do not appear to lessen other symptoms or improve quality of life, according to a recent analysis of data from the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness Alzheimer's Disease (CATIE-AD) study. The analysis was published online ahead of print June 2, 2008, in the American Journal of Psychiatry.

The 421 participants in the CATIE-AD study all had Alzheimer's-related dementia with additional symptoms such as delusions, aggression, hallucinations, or agitation that were severe enough to disrupt their functioning. Previously reported results of CATIE-AD concluded that the antipsychotic medications compared in the trial (olanzapine, quetiapine, and risperidone) were no more effective than placebo (sugar pill) when adverse effects were considered. This new analysis delved deeper to measure effects of the medications on patients.

David Sultzer, M.D., of the University of California Los Angeles, and colleagues found that CATIE-AD participants who completed the first 12 weeks of treatment with risperidone or olanzapine showed significant improvement in symptoms of hostility, aggression, mistrust and uncooperativeness, compared to placebo. However, none of the antipsychotic medications showed benefit in treating symptoms of depression, cognitive difficulties or functional disability. Further, those taking olanzapine showed increased symptoms of blunted emotions.

The researchers caution that these results show average group outcomes and may not apply to individual treatment effects. Doctors should consider each patient's circumstances, vulnerabilities and needs to determine if potential benefits will outweigh potential adverse effects, say the researchers. Sultzer and colleagues conclude by calling for additional research to identify potential subgroups of patients with certain neurobiological factors or symptom characteristics that may predispose them to specific responses to antipsychotic treatments.

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In the News…Does Mental Illness Affect Consumer Direction of Community-Based Care?

Does Mental Illness Affect Consumer Direction of Community-Based Care? Lessons From the Arkansas Cash and Counseling Program

Ce Shen, PhD1, Michael A. Smyer, PhD2, Kevin J. Mahoney, PhD1, Dawn M. Loughlin, PhD3, Lori Simon-Rusinowitz, PhD3 and Ellen K. Mahoney, DNS4

Purpose: Previous research from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, New Jersey, and Florida suggests that giving consumers control over their personal care greatly increases their satisfaction and improves their outlook on life. Still, some argue that consumer-directed care may not be appropriate for consumers with intellectual disabilities or mental health diagnoses. This study examined how Cash and Counseling-a new option allowing consumers to manage an individualized budget equivalent to what agencies would have spent on their care-changes the way consumers with mental health diagnoses meet their personal care needs and how that affects their well-being. Design and Methods: Using the Arkansas CCDE baseline and the 9-month follow-up data for individuals in the treatment and control groups, we compared and contrasted the experience of elderly consumers with and without mental health diagnoses utilizing logit regression. Results: After examining several outcome measures, including satisfaction with care arrangements and the paid caregiver's reliability and schedule, unmet needs, and satisfaction with the relationship with paid caregivers, this study found evidence that, from the perspective of consumers, the Cash and Counseling program works well for participants with mental health diagnoses. Implications: Considering the growing need for long-term-care services and the limited resources available, a consumer-directed option makes sense, and it can be a valuable alternative for persons with mental health needs.

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In the News… Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults with Depression

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Enola K. Proctor, Ph.D., Leslie Hasche, M.S.W., Nancy Morrow-Howell, Ph.D., Martha Shumway, Ph.D. and Grace Snell, M.S.W.

OBJECTIVE: Depression often co-occurs with other conditions that may pose competing demands to depression care, particularly in later life. This study examined older adults' perceptions of depression among co-occurring social, medical, and functional problems and compared the priority of depression with that of other problems. METHODS: The study's purposeful sample comprised 49 adults age 60 or older with a history of depression and in publicly funded community long-term care. Four-part, mixed-methods interviews sought to capture participants' perceptions of life problems as well as the priority they placed on depression. Methods included standardized depression screening, semistructured qualitative interviews, listing of problems, and qualitative and quantitative analysis of problem rankings. RESULTS: Most participants identified health, functional, and psychosocial problems co-occurring with depressive symptoms. Depression was ranked low among the co-occurring conditions; 6% ranked depression as the most important of their problems, whereas 45% ranked it last. Relative rank scores for problems were remarkably similar, with the notable exception of depression, which was ranked lowest of all problems. Participants did not see depression as a high priority compared with co-occurring problems, particularly psychosocial ones. CONCLUSIONS: Effective and durable improvements to mental health care must be shaped by an understanding of client perceptions and priorities. Motivational interviewing, health education, and assessment of treatment priorities may be necessary in helping older adults value and accept depression care. Nonspecialty settings of care may effectively link depression treatment to other services, thereby increasing receptivity to mental health services.