Founding Concepts for
OAK Center (Older Adult Knowledge Center)

Background

Conclusions of the Surgeon General

Important life tasks remain for individuals as they age. Older individuals continue to learn and contribute to the society, in spite of physiologic changes due to aging and increasing health problems.
Continued intellectual, social, and physical activity throughout the life cycle are important for the maintenance of mental health in late life.
Stressful life events, such as declining health and/or the loss of mates, family members, or friends often increase with age. However, persistent bereavement or serious depression is not “normal” and should be treated.
Normal aging is not characterized by mental or cognitive disorders. Mental or substance use disorders that present alone or co-occur should be recognized and treated as illnesses.
Disability due to mental illness in individuals over 65 years old will become a major public health problem in the near future because of demographic changes.  In particular, dementia, depression, and schizophrenia, among other conditions, will all present special problems in this age group: 1.Dementia produces significant dependency and is a leading contributor to the need for costly long-term care in the last years of life; 2.Depression contributes to the high rates of suicide among males in this population; and 3.Schizophrenia continues to be disabling in spite of recovery of function by some individuals in mid to late life.
There are effective interventions for most mental disorders experienced by older persons (for example, depression and anxiety), and many mental health problems, such as bereavement. 
Older individuals can benefit from the advances in psychotherapy, medication, and other treatment interventions for mental disorders enjoyed by younger adults, when these interventions are modified for age and health status.
Treating older adults with mental disorders accrues other benefits to overall health by improving the interest and  ability of individuals to care for themselves and follow their primary care provider’s directions and advice, particularly about taking medications.
Primary care practitioners are a critical link in identifying and addressing mental disorders in older adults.  Opportunities are missed to improve mental health and general medical outcomes when mental illness is underrecognized and undertreated in primary care settings.
Barriers to access exist in the organization and financing of services for aging citizens. There are specific problems with Medicare, Medicaid, nursing homes, and managed care.

  Mental Health: A Report of the Surgeon General, 1999. http://www.surgeongeneral.gov/library/mentalhealth/chapter5/conc5.html

Vision

The ten principles of good care are:

Every senior has the right to a good life
Every senior has the right to self-determination
Every senior has the right to an individual life-style
Every senior shall have privacy
Every senior shall be treated well
Every senior shall get good care
Every senior has the right to a good living environment
Every senior has the right to good and sufficient caring personnel
Every senior has the right to access to their relatives and closest friends
Every senior has the right to a good death

Finnish Association for Mental Health, 1999

Mission

To enhance the experience of aging and ease the transformation to death.

Through advocacy and public education to improve the quality of life of older persons by promoting the development of accessible, affordable, least restrictive, voluntary, age appropriate mental health services

Goal

To represent in their own voice the views of older persons with mental health concerns and mental illnesses including dementias and to serve as a primary source of knowledge on all aspects of mental health and aging.

Objectives

To decrease the elderly fear of mental health stigma by increasing public awareness and knowledge of the special mental health needs and problems of older persons, including alternative solutions and approaches to enhanced  services and treatments needed by this population group.

To advocate at all levels of government for parity to ensure that the older population group will receive its fair share of government resources and entitlement based on the prevalence of mental illness in older persons.

To promote the development and implementation of non-traditional, alternative, and complimentary mental health, early intervention, and integrated treatment programs that specifically target older persons.

To support an expedited mental health and aging research agenda and development of a national database of mental health services for older adults.

To promote increase in the specialized professional workforce which provides age-sensitive mental health services to older persons.

To develop and distribute culturally sensitive information about accessing community mental health services for older persons.

Membership

The OAK Center (Older Adult Knowledge Center) welcomes mental health consumers, older persons who are concerned about mental health issues but who may not be consumers or are unwilling to identify themselves as such,  family caregivers, service providers and professionals, and mental health advocates.

Focus will be on mental health issues related to persons over 60 but there will be no age restrictions for membership.

Voting membership and governance shall be limited to self-identified consumers over 60.   One-third of the executive committee membership shall include non-voting representation from family caregivers and professional service providers.

Consumer is someone who self-identifies as having a severe and debilitating mental illness as defined by the Surgeon General's Report.  In this document, consumer also includes proxied care-givers of consumers.  Consumers have experienced a range of mental health services that may include inpatient or outpatient commitment, restraints, seclusion, electro-convulsive therapy, peer-support services (as a recipient or a provider), public and private mental health services, physical or sexual abuse, other trauma, VA services, dual mental health/developmental disabilities, dual mental health and substance abuse histories, homelessness, SSI/SSDI or VA benefits, onset after the age of 55, co-occurring physical disability, incarceration by the criminal justice system, consumer and parent of a child with mental health needs, consumer and the adult child of a parent with dementia.  (This list is excerpted from the Call for Nominations to the Center for Mental Health Services National Advisory Council Subcommittee on Consumer/Survivor Issues.) 

Process

The OAK Center process for large and small and committee meetings shall be participatory, inclusive, and consensus driven.