At the recent White House Conference on Aging (WHCoA) 78 percent of the 1,200 delegates voted to support the resolution for training of geriatric education for health care professionals, ranking it sixth among 73 resolutions, which was touted by professional groups as a victory for geriatric mental health care.
In stark contrast, legislators a few blocks away later that week played out a very different agenda. Congress voted to eliminate all funding through the Bureau of Health Professions (Title VII) for geriatric training, including geriatric psychiatry and geropsychology fellowships, academic career awards for geriatricians and the operation of 50 nationwide geriatric education centers.
“Nothing can demonstrate more vividly that what the delegates said in this conference is not of significance regarding policy,” said Robert Binstock, Ph.D., delegate at large and professor of aging, health and society at Case Western Reserve University. The official mission of the conference is to generate recommendations for Congress and the president for dealing with the needs of the aging population and the baby boom generation. But Binstock called the conference only symbolic. “All that I can say with certainty is that 1,200 delegates went home with certificates, and $7 million was spent on the conference.”
Binstock, a delegate at two previous White House conferences on aging, stated that only one major outcome from these conferences occurred in 1971 when President Nixon advocated for a doubling a $100 million authorization for congregate meals at senior centers, part of a bill reauthorizing the Older Americans Act.
Many delegates criticized the absence of President Bush, viewing it as a snub that for the first time in 40 years the president did not speak at the WHCoA.
Norman Abeles, Ph.D., professor of psychology at Michigan State University and a delegate to two White House conferences on aging, criticized the tight management of this year’s conference. He explained that delegates presented a resolution signed by 23 percent of the members that would permit additional resolutions for a vote that would result from work groups on specific topics. Facilitators denied the request.
Binstock referred to the language of many of the resolutions as “vacuous,” pointing to examples of broad language such as “strengthening” Social Security and the Medicare program.
Mick Smyer, Ph.D., dean of the Graduate School of Arts and Sciences at Boston College and delegate from Massachusetts, was disappointed that papers he and others prepared prior to the conference were not distributed to the delegates as planned. Last May Brian Lindberg, consultant to the conference, had approached Smyer to write a “vision paper” on mental health and aging. A few days prior to the conference he learned the vision papers would not be distributed due to “technicalities.”
Some delegates felt that significantly positive results for mental health did occur at the conference, specifically the inclusion of a resolution for improving recognition, assessment and treatment of mental illness and depression among older Americans. Ronald F. Levant, Ed. D., APA President and delegate at large, called it a “major victory toward eliminating stigma of mental illness in older adults.”
According to Stephen Bartels, M.D., geriatric psychiatrist and professor of psychiatry at Dartmouth Medical School, the fact that the mental health resolution ranked eighth among the 73 resolutions “signals that the message has finally gotten across that the greatest fear of many seniors is losing their mind to Alzheimer, depression and suicide.” At the 1995 WHCoA, Bartels said, “Mental health could not have been farther off the radar screen.”
Smyer remains cautiously optimistic for promotion of geriatric mental health care and training as a result of the conference, viewing the WHCoA as “a necessary but not sufficient set of first steps.” He said that mental health advocates need to work with their local and community partners in implementing the initiatives and resolutions.
The WHCoA is a non-partisan event that occurs about every 10 years. The psychologist delegates included Levant, Abeles, Smyer, John Cavanaugh, Suzann Ogland-Hand and Margaret Hastings. APA staffer, Deborah Digilio, also worked in conjunction with the National Coalition on Mental Health and Aging. To read more about the WHCoA go to the website http://www.whcoa.gov/.
Paula E. Hartman-Stein, Ph.D.. is a consultant, clinician and political advocate in Kent, Ohio, and director of geriatric psychology at Summa Health System in Akron. She can be reached through her website, www.centerforhealthyaging.com.