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Meeting the Mental Health Needs of Adult Protective Services ClientsKim Steinhagen, LMSW, Director, Geriatric Mental Health Alliance of New York, gave this testimony at the Oversight Hearing on Reforming Adult Protective Services to Better Serve Vulnerable Clients before The Committee on Aging, Hon. Maria del Carmen Arroyo, Chair, and The Committee on General Welfare,Hon. Bill de Blasio, Chair, on June 14, 2007. Good afternoon. My name is Kim Steinhagen, and I am the Director of The Geriatric Mental Health Alliance of New York—an advocacy group formed by the Center for Policy and Advocacy of the Mental Health Associations of New York City and Westchester in January 2004 to confront the mental health challenges of the elder boom. The Alliance currently has over 2,400 members. We have workgroups on policy and advocacy in NYC and Albany. We also have consensus groups on long-term care and mental health, housing, and workforce development. We sponsor a series of presentations on best practices with national experts, have co-sponsored numerous conferences, and provide technical assistance regarding service models and funding. We are also planning for the development of a training center on geriatric mental health which would include providing training and technical assistance for non-mental health providers such as APS workers. Growth in Number of Older Adults in New York CityOver the next 25 years the number of older adults in NYC will increase 60%— from 900,000 to 1.5 million. This will result in a rise in the numbers of older people with mental disorders—from 180,000 now to 300,000 in 2030. Our helping systems cannot meet the needs of the current population. Without action now, we certainly will not be able to meet the mental health needs of the elder boom population. The majority of the clients served by APS have mental and behavioral problems that are often quite severe. Mental disorders include dementia, depression, anxiety disorders, paranoia, and schizophrenia. Behavioral problems include hoarding, wandering, refusal of or inability to follow prescribed treatment, belligerence or abuse of family or other caregivers, etc. Unfortunately adult protective services workers are not trained to address these complex problems. They often don’t even know where to refer to services. As a result many APS clients who could be managed in the community by well- trained workers are sent to nursing homes. Recommendations to APSIn order to work more effectively with clients who have mental illness, APS needs to:
Additional funding will be key to ensuring that these changes take place. Additional funding is also needed to develop more community based mental health services, including housing alternatives to nursing homes. One final note: a few NYC providers and advocates have already met with APS leadership, who appear to us to be entirely clear about APS’s problems working with clients with mental disorders and to be committed to change. They need resources to train staff, to reduce caseloads, and thus, to provide more effective services. We urge the City to provide the necessary funding. Thank you for the opportunity to testify today. Please feel free to call on us at any time for background information about geriatric mental health. Return to the top of the page.
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