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Older adults are at risk for mental health concerns, such as social isolation and suicide. Risk factors to suicide among older adults, such as loneliness and social isolation, may be impacted by the COVID-19 pandemic. Gatekeepers in the community are a significant source of identification and referral of older adults at risk of mental and physical health concerns. In this study, we sought to discover whether natural helpers in the Aging Service Network (ASN), including volunteers and providers (n = 93) obtain and utilize suicide-intervention skills with older adults who receive home-delivered meals (HDM) after being trained in a 14-hour evidenced based training. Paired-sample t-tests yielded significant results at pre- and post-test measures of suicide intervention response skill acquisition, and over 19% of trained participants reported using suicide intervention skills over six months. Implications for future training and research are discussed.

Introduction to the special issue on Medicare Inclusion of Counselors: Preparing the Counseling Workforce to Serve Older Adults. [ABSTRACT FROM AUTHOR]

Late-life suicide is a public health concern, yet many older adults do not have access to traditional mental health services. The present study sought to explore how suicide intervention is integrated into home-delivered meal (HDM) contexts following volunteer training in an evidence-based suicide first responder program. Using phenomenological inquiry, we examined the experiences of 20 HDM volunteers trained in ASIST. Three primary themes emerged: (a) Logistics influencing integration of Suicide Intervention into HDM Systems, describing HDM program logistics; (b) Intrapersonal Context, describing HDM volunteer characteristics influencing intervention utilization and HDM client concerns; and (c) Interpersonal Context, describing HDM relationship characteristics that influenced intervention utilization. HDM and other nutrition services have potential for addressing late life suicide, particularly when volunteers best equipped to address risk receive training and HDM policies reflect the needs of their clients. Implications for HDM services, as well as the Aging Services Network, are discussed. [ABSTRACT FROM AUTHOR]

Suicide in later life is a pressing public health concern, which has likely been exacerbated by the COVID-19 pandemic. Many older adults who need mental health treatment do not have access to necessary services and training for mental health providers to support older adults experiencing suicidality is limited. One solution is developing interventions based in a public health approach to suicide prevention, whereby natural helpers who provide community services are mobilised to respond to older persons-at-risk. Home-delivered meal (HDM) services, for example, are one effective means to reach older adults who are isolated due to being homebound and may be instrumental in preventing suicide. This study examined the experiences of 20 HDM volunteers who received Applied Suicide Intervention Skills Training (ASIST), an evidence-based suicide intervention programme. Phenomenological analysis yielded findings centred on three areas demonstrating the impact of the ASIST training on HDM volunteers: putting asist skills into practice; response to ASIST skills; and role transformation. Implications for integrating suicide prevention efforts with HDM services and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Despite the availability, some residents choose not to participate in wellness offerings at their residential communities. Perceptions of aging can influence engagement in healthy behaviors. The purpose of this research was to examine the relationship between perceptions of aging and wellness engagement among Life Plan Community residents. A total of 447 residents (ages 59 to 97; M = 81.82, SD = 6.55) of 10 Life Plan Communities completed surveys that measured their perceptions of aging, self-reported wellness, interest in improving wellness, participation in wellness programs, and barriers to wellness participation. Multiple regression analyses revealed that more positive perceptions of aging were associated with better wellness, higher interest, more frequent participation, and fewer barriers. Follow-up analyses revealed that these effects could be accounted for by specific types of aging attitudes (i.e. psychological growth, psychosocial loss, and physical change). These findings have implications for the development, implementation, and promotion of wellness programs for older adults. [ABSTRACT FROM AUTHOR]

Although resident wellness is increasingly a priority in senior living communities, there are few programs that promote holistic wellness in later life. A total of 79 residents (ages 71 to 97; M = 84.27, SD = 6.46) from eight senior living communities completed a pilot study of a novel, staff-led wellness coaching program consisting of resident-driven goals and individual and group coaching sessions. Participants completed surveys at three time points (pre-program, post-program, and 1-month follow-up). Repeated measures ANOVAs revealed positive changes in resident health satisfaction, physical quality of life (QOL), psychological QOL, loneliness, relatedness, competence, and sense of purpose. Some of these results (i.e., psychological QOL, loneliness) persisted at follow-up. Residents reported high satisfaction with the program. These findings have implications for the application of holistic wellness frameworks in later life, as well as the development and implementation of wellness coaching programs with older adults. [ABSTRACT FROM AUTHOR]

Although advocacy is a priority for counseling professionals, little is known about counseling advocates' participation in the legislative advocacy process. Recent legislation to address the opioid crisis allowed counseling advocates to provide public comments to advance counselor inclusion in the Medicare program. A thematic analysis of 548 public comments provided on behalf of the counseling profession yielded four categories: advocacy on behalf of (1) the proposed rule change; (2) broader Medicare inclusion; (3) the proposed rule change with an additional request for broader Medicare reimbursement; and (4) no clear advocacy. Subthemes included increasing access to care, qualifications necessary to provide care, and the urgency of the opioid epidemic, among others. Implications for the counseling profession and counselor advocacy are discussed. [ABSTRACT FROM AUTHOR]

Telebehavioral health offers a unique opportunity to expand access to mental health services for older clients by addressing systemic barriers that often render mental health care inaccessible in later life. Although health interventions facilitated by technology, including telebehavioral health approaches, proliferated at the start of the COVID-19 pandemic, little guidance exists for counselors seeking to provide such services to clients in later life. In this manuscript, we describe barriers to accessing mental health services, how telebehavioral health services can address these barriers, and practical consideration for delivering telebehavioral health approaches for counselors who work with older clients. [ABSTRACT FROM AUTHOR]

Mental health conditions are relatively common among Medicare beneficiaries. Yet, Medicare provider eligibility was last updated in 1989, raising concerns about beneficiaries' access to mental health care in the United States. Beneficiaries are currently restricted from accessing mental health services provided by licensed professional counselors and licensed marriage and family therapists. Little is known about the impact of this Medicare mental health coverage gap (MMHCG) on Medicare beneficiaries. Hermeneutic phenomenology was used to analyze semistructured interviews with 18 beneficiaries who had attempted to access mental health care but were limited due to the MMHCG. Three themes emerged: (a) exasperating experiences with the MMHCG, (b) the MMHCG compounds barriers to mental health care, and (c) Medicare as a flawed system. These findings suggest current Medicare mental health policy interferes with beneficiaries' access to needed mental health services. Implications for the counseling profession are described. [ABSTRACT FROM AUTHOR]

Across the globe, COVID‐19 has disproportionately affected the physical and mental health of several vulnerable groups. In a series of two cross‐sectional studies conducted April to July 2020, we examined its acute mental health effects on two vulnerable U.S. community samples—home‐bound older adults who were at or below the poverty line (Study 1, N = 293, Mage = 76.94, SD = 8.64; 75.1% female, 67.9% Black) and adults with chronic disease (Study 2, N = 322, Mage = 62.20, SD = 12.22; 46.3% female, 28.3% racial/ethnic minorities). Based on the conservation of resources theory, we hypothesised that pandemic‐related resource loss would be associated with greater mental distress, but perceived social support and positive psychological characteristics (trait resilience and optimism) would buffer against this adverse effect. Across both samples of vulnerable adults, pandemic‐related resource loss was related to mental distress. Perceived social support was related to lower mental distress but did not consistently buffer the effect of resource loss on mental health. However, in Study 2, both trait resilience and optimism buffered this relationship. Findings are discussed in terms of their implications for the conservation of resources theory. [ABSTRACT FROM AUTHOR]