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Objective: Increasing numbers of student service members/veterans (SSM/Vs) are enrolling in college. However, little is known about how their previous military experience affects their adjustment to this new role. The present study tested the hypothesis that SSM/Vs who report adjustment problems in college have a higher incidence of posttraumatic stress disorder (PTSD), depression, and other behavioral health problems compared with those who do not report adjustment problems. Participants: SSM/Vs (N = 173) at a large, southeastern, public university completed online surveys that included well-validated screens measuring substance use, depression, PTSD, and other mental disorders. Results: Those reporting difficulties adjusting to university life (28%) reported significantly higher frequencies of behavioral and health problems while in the military, and significantly higher levels of PTSD, depression, and mental health disorders, but no difference in substance use. Conclusions: Implications for improved behavioral health screening and coordination of university behavioral health services with veterans' health systems are discussed.

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.

Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and attitude toward aging) on depressive symptoms. A sample of 150 residents (M age = 82.8, SD = 9.41) from 17 facilities in Florida was used for analyses. Higher levels of depressive symptoms were observed among older residents with a greater level of functional disability, poorer self-rated health, lower sense of mastery, less religiosity, and less positive attitude towards aging. In addition, the linkages between physical and mental health were modified by psychosocial resources. For older residents with more positive beliefs and attitudes (a higher sense of mastery, greater religiosity, and more positive attitudes toward aging), the adverse effects of functional disability or poorer self-rated health on depressive symptoms were attenuated. The protective roles of psychosocial resources against physical health constraints yield important implications for designing prevention and intervention strategies for the mental health of older populations in ALF settings. (Contains 1 figure and 2 tables.)

Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Results: Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. Implications: The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect. (Contains 6 tables.)

There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care settings. Addressing the bio-psycho-social needs of frail, poor, and minority older adults within an interdisciplinary framework exposes geropsychology Fellows to the complex nature of mental health problems of older adults and the need for collaborative efforts across professional lines. The program builds on prior geropsychology training at the graduate and internship levels by providing an integrated framework to achieve clinical, didactic, program evaluation, and advocacy goals: (1) delivery of state-of-the-art evidence-based psychological services to disadvantaged older adults in geriatric public sector primary care sites; (2) mastery of the knowledge base on diversity and interdisciplinary teamwork as they relate to providing services to older adults, including those residing in rural areas; (3) gaining competence in the evaluation of services to disadvantaged older adults; and (4) experience in public health advocacy for improvement of the LTC system.

Objectives. We developed and examined the effectiveness of the Florida Brief Intervention and Treatment for Elders (BRITE) project, a 3-year, state-funded pilot program of screening and brief intervention for older adult substance misusers. Methods. Agencies in 4 counties conducted screenings among 3497 older adults for alcohol, medications, and illicit substance misuse problems and for depression and suicide risk. Screening occurred in elders' homes, senior centers, or other selected sites. Individuals who screened positive for substance misuse were offered brief intervention with evidence-based practices and rescreened at discharge from the intervention program and at follow-up interviews. Results. Prescription medication misuse was the most prevalent substance use problem, followed by alcohol, over-the-counter medications, and illicit substances. Depression was prevalent among those with alcohol and prescription medication problems. Those who received the brief intervention had improvement in alcohol, medication misuse, and depression measures. Conclusions. The BRITE program effectively shaped state policy by responding to legislative mandates to address the needs of an increasing, but underserved, elder population. The pilot paved the way for obtaining a federally funded grant to expand BRITE to 27 sites in 17 counties in Florida. (Am J Public Health. 2010;100:108-114. doi: 10.2105/AJPH.2008.149534)

Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and attitude toward aging) on depressive symptoms. A sample of 150 residents ([M.sub.age] = 82.8, SD = 9.41) from 17 facilities in Florida was used for analyses. Higher levels of depressive symptoms were observed among older residents with a greater level of functional disability, poorer self-rated health, lower sense of mastery, less religiosity, and less positive attitude towards aging. In addition, the linkages between physical and mental health were modified by psychosocial resources. For older residents with more positive beliefs and attitudes (a higher sense of mastery, greater religiosity, and more positive attitudes toward aging), the adverse effects of functional disability or poorer self-rated health on depressive symptoms were attenuated. The protective roles of psychosocial resources against physical health constraints yield important implications for designing prevention and intervention strategies for the mental health of older populations in ALF settings.

Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Results: Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost o times greater at approximately twice the cost compared to other service users. Implications: The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect. Key Words: Elder abuse, Mental health, Substance abuse, Medicaid, Medicare

The purpose of this article is to examine Florida's Adult Protective Services database (APS) to determine the characteristics of those who have been referred to the APS system, and the trends in reporting of types of elder mistreatment between 1993 and 1998. Comparative data are used to examine gender and racial differences, and longitudinal analysis is conducted to examine trends in reported mistreatment and different types of mistreatment. We find increasing trends in reported mistreatment that are not consistent for different categories; neglect rates declined while abuse and financial exploitation rates rose. As the Florida APS data differed from other national and state studies of elder mistreatment in ways that support the study conclusions from the National Elder Abuse Incidence Study--that the most effective way to report mistreatment may come from local agencies, rather than through the state hotline mechanism. KEYWORDS. Elder abuse, elder mistreatment, financial exploitation, management information systems data

The National Aging Network serves millions of older Americans seeking home- and community-based services, but places others on waitlists due to limited resources. Little is known about how states determine service delivery and waitlists. We therefore conducted a process evaluation and analyzed data from one five-county Area Agency on Aging in Florida, where an algorithm calculates clients' priority scores for service delivery. From 23,225 screenings over 5.5 years, clients with higher priority scores were older, married, living with caregivers, and had more health problems and needs for assistance. Approximately 51% received services (e.g., meals/nutrition, case management, caregiver support), 11% were eligible/being enrolled, and 38% remained on waitlists. Service status was complex due to multiple service enrollments and terminations, funding priorities, and transfers to third-party providers. More research is needed regarding how other states determine eligibility and deliver services, potentially informing national standards that promote optimal health in older Americans. [ABSTRACT FROM AUTHOR]

Staff providing services to older adults in Florida and North Carolina were asked to estimate the prevalence of alcohol abuse and medication misuse among their clients. Although there were high prevalence rates in both states, Florida estimates were greater, especially by staff offering on-site rather than in-home services. Estimates of direct care and administrative staff did not differ. Few staff received in-service training on substance abuse issues, despite ranking the topics of 'medication misuse' and 'counseling older substance abusers' as highest priority. Results are discussed in terms of the different samples and methodology used. Implications for further training and research are discussed.

Significant numbers of new arrestees to jail have a history of drug or alcohol use. Many of these individuals have experienced multiple relapses, which tend to accelerate the level of criminal behavior and to increase the likelihood of arrest and incarceration. The present study examines the pattern of determinants of recent substance abuse among inmates referred for treatment in a metropolitan jail. The majority (87%) of inmates reported intrapersonal determinants of recent use, including coping with negative emotional states (41%) such as depression, anxiety and tension, and enhancement of positive emotional states (35%). Although no major differences in the pattern of determinants were found with respect to the type of major problem substance reported, several gender differences were observed. Implications for the design of substance abuse treatment programs within the criminal justice system are discussed, and recommendations are presented for further research investigating differences between determinants of 'relapse' and 'recent use' among offenders.

Early-onset and late-onset elderly alcohol abusers both report similar antecedents to recent drinking, such as depression, loneliness and lack of social support. Early-onset abusers were more likely to have moved residences, were drunk more frequently and experienced higher depression and anxiety levels, though. Late-onset abusers, on the other hand, reported greater satisfaction and motivation for treatment. These findings were gleaned from a comparison of antecedent to recent drinking of the two groups of elderly alcohol abusers.

OBJECTIVES: For older adults screened by an Area Agency on Aging (AAA) in the National Aging Network, we aimed to examine the 12‐month mortality rate for wait‐listed callers compared with those who received services within 12 months, and to assess whether the mortality rate differed according to how quickly they received services. DESIGN: The design was a longitudinal analysis of 3 years of AAA administrative data, using survival analysis. SETTING: The data source was administrative data from an AAA spanning a five‐county region in west central Florida. PARTICIPANTS: All older adults (age 60 y and older) screened for service eligibility from July 15, 2013, to August 15, 2015, who completed initial screening during the study period were included (N = 6288). MEASUREMENTS: The outcome was mortality within 12 months of the initial screening. Covariates included demographics, caregiver status, health status, access to healthcare, and AAA service status. RESULTS: In the first survival analysis, the strongest predictor was waiting for services compared with receiving services; waiting increased the odds to die vs not to die by 141%, after controlling for health status and other covariates. In the second survival analysis, those who received services within 0 to 3 months had a higher mortality risk compared with those who received services within 6 to 9 months or 9 to 12 months. CONCLUSION: Older adults placed on aging service waiting lists may be at a greater risk of mortality within 12 months than those receiving services. Given that rapid receipt of services was less protective than receiving services later, those prioritized to receive services quickly may be at very high risk of adverse outcomes. Findings raise the possibility that aging services may lower mortality, although additional services may benefit those waiting long periods for services, as well as those eligible for services rapidly. Research is needed to replicate and extend these findings. J Am Geriatr Soc 68:519–525, 2020 [ABSTRACT FROM AUTHOR]

Suggests a method to encourage proponents of opposing models of alcoholism treatment to work together. Emphasizes relapse prevention skills; deemphasizes etiological arguments. Claims traditionalists and antitraditionalists can, by joining forces, create treatment programs which offer standard group processes, and new components for more specific problems. (Author/ABL)