Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Intercommunity Action

Name of Innovative Program: 
Behavioral Health Services for Underserved Older Adults
Sponsoring Organization
Intercommunity Action
Name of Innovative Program Lead: 
Steven May
E-mail Address of Innovative Program Lead: 
stevenmay@intercommunityaction.org
Project Description: 
 Untreated behavioral health problems among older adults too often contribute to  a downward spiral resulting in increased physical illness, disability, and even death.  Yet, older adults underutilize traditional behavioral health services.  With creative thinking and innovative approaches, Journey’s Way(JW), the aging services division of Intercommunity Action, successfully engages and treats this hard to reach population, improving life for almost 600 older adults yearly.JW’s Geriatric Counseling Service uses non-stigmatizing approaches to educate elders and their families and brings individual treatment to 200+ older people yearly, serving them in their homes and in community sites.  JW’s extensive outreach educates and engages community gatekeepers - helping them understand and identify behavioral health problems and refer elders in need to JW services.  JW also developed and runs a nationally-recognized peer counseling program that reaches more than 350 elders yearly, filling gaps in treatment for older adults with depression or who are at risk.
Creativity and Innovation: 
 JW pioneered mobile therapy and peer counseling programs for elders, and continues using ingenuity and creativity to overcome barriers to treatment.  JW uses its position as a multi-service agency for older adults to continually reach out and educate elders, community networks, professionals, doctors, apartment managers, home health workers and others.  This broad network recognizes elders in distress and calls JW to request an assessment phone call and visit.   75% of elders referred this way accept treatment after talking to a JW clinician.  JW carefully trains staff to use non-stigmatizing language in all outreach and client services.  Avoiding behavioral health terms and jargon makes services more acceptable to elders who often perceive a stigma to behavioral health services. The peer counseling program fills gaps in service by helping older adults “step down” from individual treatment, providing enhanced service at senior centers and identifying and referring older people who need individual counseling. 
Leadership: 
 For more than 25 years, JW has led by example – offering non-stigmatizing, readily accessible treatment options for older adults.  JW staff serve as resources throughout the aging community.  Staff provide free consultation to various referral sources (including senior centers, physician offices, congregational leaders), helping them identify older adults with behavioral health needs, engage elders and link them to services.  In 2011, JW was awarded the Deirdre Johnson Award for Excellence in Innovation in Geriatric Mental Health from the American Association for Geriatric Psychiatry/Geriatric Mental Health Foundation.  In 2012, JW was one of 10 agencies the Foundation invited for a national conference discussing best practices in behavioral health services for older people.  Conference results are summarized on the Foundation website and Foundation staff are preparing an article for publication.  JW staff present regularly at conferences and are part of this region’s on-going conversation around the behavioral health needs of elderly people. 
Sustainability: 
 JW began providing in-home behavioral health treatment 25 years ago.  Since then, JW has successfully sustained and grown its behavioral health services for older people.  Currently, JW receives funding from the Philadelphia Office of Behavioral Health, the Pew Charitable Trusts, and United Way for these programs. JW’s parent organization, Interact, has a strong development office which raises funds for all the agency’s programs, including JW’s behavioral health services.  This funding allows JW to support the Geriatric Counseling Service (which includes seven licensed social work clinicians and a licensed supervisor with 30+ years of experience with older adults and the behavioral health system) and a program coordinator for the peer counseling program.  Funding limitations impact the level of JW service and often mean that elders have a 4-6 week waiting period before service can begin.    
Replicability: 
 JW’s non-stigmatizing, community-based approach can be readily replicated by other organizations.  In fact, its strategies for engaging hard to reach older adults through community networks, non-stigmatizing language and mobile therapy were cited as a “promising practice” by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).  JW’s model was replicated in a SAMHSA-funded project in Arizona.JW’s programs are well documented.  JW’s peer counseling program, for example, documented its volunteer recruitment, training and supervision practices for peer leaders and developed curriculum modules for its sessions.  This allows other agencies to create a similar program.  JW staff regularly present information about the organization’s behavioral health programs and strategies at regional and national conferences. 
Results/Outcomes: 
 “I remember before you came.  All I wanted to do was die.  But then someone (from JW) came along, and helped me to see things in a different way…I am so much better.  I see things in a different light, no longer wanting to die.” – JW clientJW measures its outcomes based on improvements in older adults’ lives.  Staff collect data on effectiveness in 1) reaching older adults and 2) addressing behavioral health problems.  Staff use standardized, validated assessment tools as well as tools developed by consultants for JW.  These include an assessment of impact across 5 domains of life for individual counseling clients and pre/post surveys that measure life satisfaction and socialization (important factors in depression) for participants in peer counseling programs. JW meets outcome targets, including having 80% of those completing individual treatment show improvement and having 80% of respondents to pre/post surveys show improvement or maintenance.
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