Northern New York Rural Behavioral Health Institute

National data suggest that 20% of older Americans—33% in rural areas—suffer from depression, anxiety, or both; approximately 12% report alcohol misuse, and the suicide rate of elders is the highest amongst all age groups. Rural elders have much lower rates of health and mental health service use than older adults elsewhere. The North Country Behavioral Healthcare Network (NCBHN), established in 1997, comprises 20 nonprofit community-based behavioral health care providers delivering services in six rural counties in the northernmost reaches of New York State. In 2008, NYHealth awarded NCBHN a grant to support the HealthNet: Mental Health Services for North Country Elders project, which served older residents in the sparsely populated Central North Country area of New York State, including the St. Regis Mohawk reservation.

Led by NCBHN–a coalition of three clinics providing mental health/substance use (MH/SU) services, five human service agencies, and the University of Albany’s Institute of Gerontology–HealthNet increased screening and referrals for elders and older Native Americans, strengthened and reorganized existing community MH/SU services, and supported service expansion. It included a rigorous training program which trained individuals located in a variety of senior service clinics and agencies to provide screening, referral, and case management services. Additionally, key professional staff members of non-mental health provider agencies were trained to recognize and understand geriatric MH/SU use issues and how cultural differences impact these issues; to perform standardized mental health screenings; and to refer patients to appropriate services.