Pilot Program Brings Mental Health Care to Some Elders at Home

Caregiver, patient expert

According to the Healthy Aging Program at the Centers for Disease Control and Prevention(CDC) and the National Association of Chronic Disease Directors (NACDD), it is estimated that 20 percent of people age 55 years or older experience some type of mental health concern. These agencies say that the most common conditions include anxiety, severe cognitive impairment, and mood disorders such as depression or bipolar disorder. Mental health issues are often implicated as a factor in cases of suicide.

A significant number of family caregivers also fight depression and other mental health issues. The NIH says that psychosocial interventions have been demonstrated to reduce caregiver burden and depression.

Some of that caregiver burden stems from battling to get the caregiver’s loved one bathed, dressed, and transported to medical appointments. To have the option of a house call from a medical professional is only a dream for most caregivers and their care receivers, but this small miracle is actually occurring for some fortunate people through a pilot program called Insights.

A press release describes Insights as an innovative approach to delivering behavioral health care to seniors and their caregivers in their homes or other locations of their choice and in their primary language. According to the press release, the Insights team of therapists can deliver services in English, Spanish, Vietnamese, and Korean. Program services are grounded in scientifically tested, evidence-based practices, and provided by licensed therapists at no cost to residents of Los Angeles and Orange counties.

Dr. Romilla Batra, chief medical officer at SCAN, the organization that funds Insights, describes the program in this way:

As an organization resolutely committed to serving seniors, we recognize the need to seek new and creative solutions to address the needs of aging adults as well as those who care for them. By taking services directly to seniors in their homes, and offering counselling that is culturally and linguistically sensitive to their needs, we have seen improvements in depression, anxiety and quality of life.

HealthCentral conducted an email interview with Dr. Batra shortly after she presented her initial findings from the Insights program during the Presidential Poster Session at the 2017 Annual Scientific Meeting of the American Geriatrics Society on May 18 in San Antonio, Texas. The abstract of the research explains much of what she shared in her presentation.

HealthCentral:  Dr. Batra, taking the services into the senior’s homes is the answer to many a caregiver’s prayer. Will these professionals be social workers, nurses, nurse practitioners or doctors? How do you recruit and pay them when house calls have all but disappeared?

RB: Insights is a novel program given its innovative approach to delivering behavioral health services in the patient’s home that is both culturally sensitive and in their language of choice. Insights provides a team of extensively trained professionals consisting of licensed clinical social workers and licensed marriage and family therapists.

HC: How will Insights recruit enough professionals to deliver these services in all of the different languages?

RB: With one of the goals to deliver services in multiple languages in order to meet the diverse needs of the senior and caregiver community, we identified English and Spanish to implement at the start of the program and have already added Vietnamese and Korean. As we scale the program, we will continue to evaluate how to best meet the needs of the seniors and caregivers we are serving.

HC: If the program is provided at no cost to the recipient who pays for it?

RB: Insights is funded by SCAN; in addition to our health plan, community giving is an important focus for the organization. As part of our community based efforts, SCAN has dedicated resources for various programs—such as Insights—to directly meet the previously un-met needs of seniors.

HC: How will the program identify those in need? Referrals from doctors? Family?

RB: The Insights program reaches individuals in need through self-referral, provider organization referrals, community organizations, as well as SCAN’s member services and Independence at Home. More information and contact can be found at 866-421-1964.

HC:  Considering that funding for something as proven as Meals on Wheels could be on the chopping block for federal funding, do we dare hope that a visionary program like this will not only survive its first phase, but grow?

RB: When we created Insights, we let the goals we identified for seniors and their caregivers shape the design and structure of the program, so that we could achieve optimal patient and treatment outcomes. With this strategy, it enabled us to identify and deploy more readily available resources, such as social workers. It also allowed us to work to lessen the stigma of mental health treatment and associated reluctance to go to an outside facility by offering service within the home.

With Insights, we are on a mission to prove this type of approach can be deployed in a cost-effective manner, leading to reduced clinical costs and improved patient results. To-date, we are on the right path to achieve that; during the program implementation phase, rates and severity of depression and anxiety were reduced among program participants and quality of life scores improved. It’s our hope that as the program grows, we can share its validated results with other organizations at a national level to effect greater change in the lives and health of seniors who suffer from behavioral health issues.

HC: Thank you, Dr. Batra, for your information. I believe that most care partners – both those with any type of mental illness and those who care for these seniors – are cheering on this pilot program. Services of this type are badly needed across the nation. I hope that you’ll be able to provide us with an encouraging update in the future.

Insights was started as a pilot project in early 2016 by Independence at Home, which is a SCAN Community Service, in collaboration with researchers from the University of Washington.   See More Helpful Articles

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