SECTION 10 Mental Health

SECTION 10 Mental Health Services

Through the Annual Health and Wellness Evaluation (AHWE), the community’s Nurse Practitioner will complete assessments that will determine the potential need for mental health intervention or services. The Acts Mental Health Clinicians (MHC) serve as key members of the interdisciplinary care team and provide behavioral health, assessments, care planning, therapy services, behavioral intervention, and case management to the independent living population.

The MHCs are clinical licensed Social Workers or Psychologists that conduct diagnostic interviews to identify psychosocial strengths and weaknesses and inform care planning. They also provide individual, family and group psychotherapy services, as indicated through assessment and care planning processes; they offer caregiver support and education to family members and provide educational programs to the Acts community staff.

Referrals for the Annual Health and Wellness Evaluation can be scheduled by birthday month, unless identified as needing an assessment sooner. The cognitive assessment(s) that are recommended for an annual visit are either a SLUMS or MOCA

SLUMS- St. Louis University Mental Status Exam* MOCA- Montreal Cognitive Assessment * *See SECTION 6, Primary Care Services for a copy of the SLUMS and MOCA exam. The MiniCog and GPCOG are two additional options for cognitive screenings. If a severe cognitive deficit is detected, a KELS might want to be considered. - KELS is the Kohlman Evaluation of Living Skills- it is a more detailed assessment of all aspects of independent living skills. In addition to a cognitive screen a mental health screen should also be conducted - GDS- Geriatric Depression Scale- this is a yes/no questionnaire which has 30 questions. A point is given for each question that is indicative of depression, up to 9 is considered within normal limits.

- If someone scores above the normal threshold, they can be referred to the LCSWC If the assessments indicate a cognitive deficit or depression the Wellness team should discuss the findings with the resident and/or family, the primary care practitioner should be made aware if it is not an ACTS provider and develop a plan of care to make provisions for the resident to safely continue to live in Independent Living, such as ACTS Home Health or make arrangements to transition to a higher level of care. A detailed assessment should also be conducted either by the ACTS practitioner or other primary practitioner to obtain a proper diagnosis.

STAFF

• LCSWC • Psychologist • LPC

MENTAL HEALTH SUPPORT

All incoming residents will have a basic mental health screen that includes a SLUMS, PHQ9 and GDS as well as a short mental health questionnaire (separate questionnaire or part of another assessment as to not overwhelm)

• Support new IL residents without mental health issues o prior to admission and within 30 days meet with resident to discuss services offered to support mental health • Support new IL residents with mental health concerns o Prior to move in the LCSWC will meet with the resident to go over results of assessments and what supports we offer and what we feel they need to assimilate into the community successfully. o connect them with the wellbeing coach • Support existing residents with mental health concerns o annual review or team referral or self-referral as a way of identifying those living with mental health concerns and develop a custom plan of support o frequency of visits and by whom o other team members to be involved, i.e. nurse practitioner o goal setting • LCSWC to provide ongoing programs and education o mental health newsletter articles o group counseling o workshops o individual counseling • Educational programs o Fitness o wellness coach to develop a fitness routine (exercise has been proven to be a more effective antidepressant than medication for mild depression) • Stress management o support groups o wellness groups ▪ self-care- Emotional Wellbeing Resource Guide (Melanie and I will be working on this) ▪ spiritual groups ▪ pet therapy

• Nutrition o eating for better mental health • Social engagement o finding a purpose- volunteering o book clubs o happy hour o game clubs (mahjong, rumi, bridge)

FORMS AND ASSESSMENTS

o PHQ9 o GDS o SLUMS o KELS (as needed)