This chapter presents a brief overview of some legislative efforts within the mental health (MH) arena and examined their limitations and application with respect to older adults and people living with mental illness. The chapter also takes us through a journey to examine the current status of MH and older adults, with a particular emphasis on depression, anxiety, and schizophrenia. It discusses and reviews the programs, services and issues still outstanding within the MH arena. The chapter helps the reader to understand specific components of the Community Mental Health Act and other MH-related legislation. Many of the community day hospital programs and community MH programs administered through the Community Mental Health Act are based on the deinstitutionalization paradigm since the goal is to treat people outside the institution and within community settings. It concludes with laying out some challenges for the future in the area of MH and older adults.
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This chapter discusses the history of the Medicare in the United States; specific components of Medicare Parts A, B, C, and D; and how Medicare provides healthcare resources to older adults and people with disabilities. Medicare, a healthcare program perceived to be a universal program rather than one based upon a needs test, currently provides healthcare to people who reach the age of 64. Comprised of four parts, it can provide hospital care, general healthcare, hospice care, home healthcare, and prescription drug coverage. The chapter provides an overview of the Medicare program, its various components, and aspects of healthcare that are covered through its component parts. Although there are currently no needs tests or limitations as to who qualifies for services, the chapter concludes with some dilemmas for the future of healthcare coverage, including “an empty pot at the end of the rainbow” and rationing of healthcare services and procedures.
This chapter helps the reader to understand how to use tools such as health behavior models, the media, coalitions, and needs assessments to bring a vision to fruition and how to use advocacy tools for policy and program development. It also helps them to understand how to use advocacy tools to influence the practice arena for older adults and people with disabilities. The chapter reviews the various tools and strategies, along with policies that have been addressed thus far, and integrate these issues and skills with one’s vision for either program planning or policy development. When considering program development, all tools and strategies related to policy development apply equally. Some additional strategies or tools to use for program development include the health behavior models. This chapter attempts to integrate the theories and concepts and suggest how a program planner or policy advocate can apply them.