. .DOCUMENT. RESUME ED 216 303 CG 015 987 TITLE MentalHealth and the Elderly: Recommendations for Action. The Reports of the President's Commission on Mental. Health:. Task Babel on the Elderly and the Secretary's Committee on Mental Health and Illness of the Elderly. INSTITUTION Administration on Aging (DHEW), Washington, DC. Federal_Council on the Aging. REPORT NO DHEW-OHDS-,80-20960 PUB DATE 79 NOTE 130 -p.; Material made available at the White House Conference on Aging (3rd, Washington, DC, November 30-December 3, 1981). For related documents,see CG 015 980 -986 ,and ED 215,257-289. AVAILARLE FROMSuperintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. 'EDRS'PRICi MF01/PC06 Plus Postage. DESCRIPTORS *Delivery Systems; Emotional Problems; Geriatrics; Gerontology; *Health Needs; Health Services; *Mental Health Programs; *Needs Assess&nt; *Older Adults; Outreach Programs; *Public Polity; Research Needs ABSTRACT . L ' This publication contains the reports of two major public advisory bodies which studiedand conducted hearings on mental 'health needsof the elderly and developed recommendations for public policy to a4dresthese needs. The first report reviewscurrent mentaNhealth needs and considers:the projected needs for dealing . 'with emotional stress during the next 25years and lists seven ...-kecomMendations'for public policy loased on existing laws and institutions. The second report deals with future needs, ofmental health facilities, manpower training and research, the appropriate care of th0 elderly in mental ,institutions, and proposals for implementing recommendations from the41971 WhiteHouse Conference on \1/4 Aging about mental health of the elderly. (JAC) 1 ,-.' . I , ******************i*********ft****************************4*************. * Reproductions supplied by EDRS are the best thatcan be made , 'from the original document. ******************************************A*************************** 1. MENTAL HEALTH AND THE ELDERLY' RECOMMENDATIONS FOR ACTION THE REPORTS OF: THq PRESIDENT'S COMMISSION ON MENTAL HEALTH:TASK PANEL ON THE ERLY THE SECRETARY'S Caviva= ON MENTAL HEALTH Ai) ILLNESS OF THEELDERLY DHEW Publication Noz(OHDS)8D,Z0960 # U.S. DEPAIITMENT OF EDUCATION NATIONAL INSTITUTE OF EDUCATION "PERMISSION TO REPRODUCE THIS . EDUCATIONAL RESOURCES INFORMATION MATERIAL HAS BEEN GRANTED BY -.CENTER (ERIC) o. OTiles ''document has been reproduced as reflived from the person or organization onginating it a Minor changes have been made to improve )4reproduction quality o Points of view or opinions stated in tha docu TO THE EDUCATIONAL RESOURCES merit do not necessarily represent official ME INFORMATION CENTER (ERIC)," 03 position or riolic1r., L.rs U.S. bEPARTMENT OF HEALTH, EDUCATION,AND WELFARE Federal Council on the Aging aj - - For sale by the Superintendent of Documents, U.S. Government Printing Office,Washington, D.C. 20102 0 r Of eL V manoDucrioN The Federal 06-Ur-loll on the Aging,as a public service, and in recognition of the import of the subject to the hdalth and well-being of,theNation's elderly is pleased to'pUblishthisreport: Mental Health and the Elderly: Recommendations for Action. The publication contains inone document the reports of the two major public advisory bOdieswhich during the period 1976-1978 studied and conducted hearingson the issue of the mental health needs of. the elderly and developed recommendations-forpublic policy to address these needs. , The Secretary's Committeeon the Mental Health and Illness of the Elderly was established by Congressional mandatefor one year's duration to conduct a study And make iecommendatiwsto the-Secretary of H.E.W. for submission to the Confess in threear.bas: 1) the future needs for mental health facilities, manpower, research and training to meet themental health needs of elderlypersons, 2) the appropriate care of elderly individual'S 'who are in mentalinstitutions or who have been discharged. from such institutions, and 3)proposals for implementing threcommenda- tions of the 1971 White HouseConference on Aging. The report was transmitted oh May, 1978. ° The Presidential Commission on MentaP-Beaith, establishedbyExecutive t Order in -'ebruary, 1977 and a.broadermandate: to review themental health -needs of the Nation as a whole and to make recommendationsto the President as to how the Nation might best meet phese needs. Special task I* panels made up of the Nation'sforemost authorities in mental health Were formed to address 5reas of specializedneed. Thei.report of the Task Panel on the Elderly is presented in this FCApublication. publication of the mile tit:To-reports comprising the presentdocument does not entail d rsement by the Council -of the individualrecommendations, we believe the overall thrust of the recommendationsprovides the frame- work for a wmprehensive national policy on rental health ,and theelderly. We are, therefore pleased. to present this report as part, of,theYCA's on-going policy of publishing,anddisseminating documents of vital importance in the field of aging. , , Nelson H. Cruikshank, Chairman Federal Counci]. on the Aging Dater 'November 1, 1979 - yf TABLE OF CONTENTS **% 4r. Page THE REPORT Or41HE PRESIDENT'SCOMMISSION ON MENTAL HEALaHi TASK PANEL ON THE ELDERLY 1 . 9 THEREPI;KiOF11HE SECRETARY'SCOMMlirtl, ONMENTALAEALTH AND ILLNWS(W THE ELDERLY 33 . ., , d ro 410 ° 2` \ 1. o 1 10, I a q .. , O e vz,, R Ny '. 2 1 .. L r .. , it' 1!I ', ,.4.J.,I.I. c. .- * s ., .1d -. :- , e i 1 4 ... .4 REPORT OF THE TASK PANEL 1 ,ON MENTAL HEALTH OF THE ELVERLy l r SUBMI1 .a.) TO THE PRESIDENT'S CCMAISSICN CN MENTALHEALTH N 4 N F. ;February 15, 1978 , a ft. ., , Y 1 mt I 4 N. / A 4 `-THE PFSSIDENT'S COMMISSION ON MENTAL HEALTH , RoSalynn Carter, Honorary Chairperson Thomas E. Bryant, Chairperson?, Florence Mahoney Ruth B. Love, Vice- Chairperson - Martha L. Mitchell Priscilla Allen Mildred. Mitchell- Bateman Allan Beigel - Harold Richman Jose A. Cabranes Julius B. Richmond, Ex-Officio John J. Conger . Reymundo Rodriguez allomdS Conlan George Tarjan Virginia Dayton Franklin E. Vilas, Jr. LaDonna HarriA Glenn E. Watts, ,A Beverly Long Charles V. Willie MEMBERS OF TASK PANEL ON THE ELDERLY Richard, W. Besdine,' M.D. Hebrew Rehabilitation Center .for the Aged Rosinaale, Massachusetts Robert N. Butler, M.D. Director' Natipnal Institute on Agingi, Bethesda, Wyland Charles M. Gaitz, M.D. Head,*Spedial Clinical Services Division Texas Researeh Institute of Mental Science Houston, Texas- ,. Maggie Kuhn Convenor 4 ypeCrey Panthei..s Philadelphia, Pennsylvania The Hondrable Carl Takamura HoUse,of Representatives Ninth Legislature Hawaii State Capitol Honolulu, Hawaii -71 Although the Commission has adopted certain of the optios proposed by the tasJ panels, the opinions and recommendations-contained in the panel reports should be vieved'as those of the panel mehers; they do notneces- sarily reflect the views of the Commisgion. Rather, their publication is Airitended to share with the public the valuable info 4oh these.individualS so generously contributed to,the Commission. Oy 7 d a 4 ExECUT IVE SUMMARY 4 The explosion in absolute numbeis andreixe proportions of older people represents a human triumph., What itreally means is that womenno longer die in childbirth, childrenno longer die'at birth and.in childhood, and for the first time we have the opportunityfor great numbers of three- or even a multigenerational families. , This dramatic change in debographics,however,alstmeans'thereare de- justments that have to be made. One of the Commission's charges iS1/4todetermine who are among the under- served. Certainly children are; certainlyolder people are. The field of geriatrics, gerontology, and mentalhealth of the aged has beena very under- nourished one:, The problems are'massive: depression escalates decade by decade; 25 percent of all the suicides are committed by peopleover 65 years of age; we face the devastating organic brain syndrome;we face all the same crises in everyday problems that people of all ages do, ifnot more so. Yet, less than 3 pergent.of the budget of the National Institute ofMental Health has been devoted to the totality of services, training,and research on the plight of the older Americans. , . Another charge of the Commission is to consider the projected.needs for dealing With emotional stress during the next 25years. By then, we will dh enormous numberof have Americans on the brink of old age.By the years 2020- 2030, as many as one out of every five Ameridanswill be over,65. The extent, incidence, andprevalence of emotional and in later rars have been mental problems qeriously -underestimated: Thisisbecause statistics have depended upon utilization rages in calamity hospitalsand mental health centers, and older people have been systematically excludedfrom and trans- ferred out of public mentalhospitals into communities for them. ill-prepared to care This has kept-older peopleand their problems outside Of the best of American the mainstream medicine in the mental healthcareasystem. The burden does not fall only upon older peoplebut on their families- their middle-aged children and their grandchildrenas'well. The middle-aged bear the responsibility of supporting both ends of thelife cycle; they feel the pain of forced choicesbetween helping their parentt children. or helping their Our panel carefully, deliberately, and.quite Conservatively seven major and cost-effective selected options. We wanted to be realistic. made use of what already, exThts We have on the books legislatively andhave