volume 7 number 1 summer 2004
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d o e a releases mental health substance abuse report
The Florida Department of Elder Affairs (DOEA) released the report Mental Health and Substance Abuse Needs of Elderly Floridians: Implementation, Recommendation, and Progress on February 14, 2004. In the 2003 special session, the state budget (SB 2-A) passed with the requirement that DOEA and the Department of Children and Family Services (DCF) implement a coordinated policy to identify and refer elderly persons with mental health or substance abuse problems for treatment. This report addresses DOEA and DCF's activities and was submitted to the Governor and Legislature as required.

Actions taken by DOEA and DCF are detailed in the report.

Recommendations include:

  • Develop and issue a coordinated policy to inform all aging services entry points as to the signs of mental and substance abuse problems with elders.
  • Instruct the aging network to consistently collect data on mental health and substance abuse problems.
  • Use the DOEA data format to provide an annual report on the incidence and prevalence of mental health and substance abuse problems on local, regional and statewide levels.
  • Agencies are to collaborate on mental health and substance abuse initiatives on both a pilot as well as statewide basis.
  • Enhance communication between agencies specifically related to elders and the mental health and substance abuse system, including cross training for staff of both agencies.
  • Commit to an inter-agency agreement to enhance elders' access to mental health and substance abuse treatment.

For more information or a copy of the report, contact Sam Fante at Fantes@elderaffairs.org.

screening brief intervention and brief treatment of substance abuse problems in older adults the florida model s b i r t
Despite reports that substance abuse among older adults is a serious problem, only about 2% of adults in treatment are age 60 or older. To address this issue, the Substance Abuse Program Office of the Florida Department of Children and Families (DCF) has funded a pilot program known as "SBIRT" which stands for screening, brief intervention, referral, and brief treatment. The Florida SBIRT model offers age-specific services with a high priority on low income and minority elders. Treatment is provided by Broward County Elderly and Veterans Services, Gulf Coast Jewish Family Services in Pinellas County, and Coastal Behavioral Healthcare in Sarasota County.

Carol Barr-Platt of the Florida Mental Health Institute (FMHI), who is assigned to the Substance Abuse Program Office of DCF, is coordinating the project. She noted that, "each agency in the pilot program will work with 'non-traditional' referral sources such as county aging services, senior housing, and health clinics to identify problems. When a referral is made, the older adult is interviewed at home about problems related to alcohol, medications, or illicit drugs, as well as depression and suicide potential. Those screening positive are offered brief interventions or treatment."

Dr. Larry Schonfeld, Professor in FMHI's Department of Aging and Mental Health at the University of South Florida, is responsible for developing the treatment model and evaluating the pilot program. According to Schonfeld, "This project is the result of collaboration among the DCF Substance Abuse Program Office, the Florida Office of Drug Control Policy, FMHI, and local communities. Using new funds, Florida is able to provide innovative services to reach underserved elders. This age-group is a high priority for our state.

Dr. Kristen Lawton-Barry of the University of Michigan Alcohol Research Center, a national expert in "brief interventions" and consultant on the project said that, "Brief interventions involve brief advice and feedback to elders about their health. We've used this approach successfully in Wisconsin, Michigan, and California. Staff uses a simple workbook as a guide to negotiate, not dictate, treatment goals such as stopping or cutting down on drinking. Rather than using confrontation or labeling, staff are supportive and help motivate people to change their behavior."

Dr. Larry Dupree, Chair of FMHI's Department of Aging and Mental Health, and Dr. Schonfeld, developed the "brief treatment" recommended for this pilot based on work they have been conducting since the late 1970's. They co-authored a 16-session group treatment manual that will be published by SAMHSA as a best practice approach. "This SBIRT approach will focus on early identification for those at risk of these problems, and relapse prevention for those with more serious or severe problems," Schonfeld said. "DCF has made a great commitment with this pilot program. It has great potential for expanding to other regions in our state, and it allows us to increase our collaborations with the Florida Department of Elder Affairs, that is also working towards identification and referral of elders with mental health or substance abuse problems."

For more information about the SBIRT Project, please call Carol Barr-Platt at (850) 410-0315.

© 2004, Florida Coalition for Optimal Mental Health & Aging