States' Community Long Term Care (CLTC) Response to Mental Disorders

          Principal Investigator:  Nancy Morrow-Howell, PhD, Co-PI

          Funder: CMHSR funded pilot (through NIMH - P30 MH068579)

          Timeframe: 09/04-07/06

          Affiliation: Center for Mental Health Services Research (CMHSR)

Project Staff: Enola Proctor, PhD, Co-PI;

                       Brian Perron, MSW and NIMH pre-doctoral trainee

Participating Organizations: Division of Senior and Disability Services (DSDS)                                  

Project Contact:   Nancy Morrow-Howell, nancymh@wustl.edu; Phone: 314-935-6762

 

Project Update as of 2/26/07:
Stage: Completed

 

Description: In 1999, Drs. Morrow-Howell and Proctor studied the response of U.S. public CLTC systems to depression. Semi-structured interviews were conducted with the state directors or administrative assistants in 34 states.  Only a few states reported using public funds to provide specific mental health services to clients. About 6% of the states reported that they provide worker training in mental health; 15% provide mental health assessment services; and 15% provide mental health information and referral services. About 35% of the States report formal linkages between CLTC and mental health agencies, with these linkages largely referrals to an agency without specific protocols or inter-agency procedures. Sixty-eight percent reported formal links to the State Department of Mental Health, nearly always administrative linkages such as shared funding, joint committees, and joint attendance at executive staff meetings/ budgetary meetings. Linkages were often focused on dementia. Pilot findings indicate that CLTC systems in the U.S. are not very advanced in their assessment of mental disorder. Standardized screening instruments are rarely used. Only a small number of states are systematically implementing any mental health services; and well-developed inter-organizational referral and treatment protocols with mental health programs have not been established.

 

The current project will include all 50 states, use an improved survey, and get up-to-date information.  We want to document the status of depression detection, treatment/intervention at a national level to increase the generalizability of our collaborative work in Missouri.

 

Progress in Year 1 - 9/22/05-7/31/05:  For the Survey of States project, the major accomplishments were organizing a research team, explicating the research aims and study questions, and working toward the collection of data. The collection of data is occuring in two parts. The first part consists of a critical examination of each state's instruments used for eligibility determination with an emphasis on health and well-being. Approximately one-third of the instruments have been obtained. The second part of data collection consists of telephone interviews of each state's Unit on Aging. The interview schedule is completed and will be integrated into the database to allow for computer-assisted administration.

 

Plans for Year 2 - 8/01/05-7/31/06:  During this period the team completed data collection for both parts of the study and data analysis.  The group is preparing to report the findings in peer-reviewed journals and at  mental health services-related conferences.