"A double whammy" is how Paolo del Vecchio, M.S.W., describes the plight of older people who have mental illnesses. "These older adults not only experience discrimination related to getting old, but they face the stigma associated with mental illness on top of that," said Mr. del Vecchio, Associate Director for Consumer Affairs at SAMHSA'S Center for Mental Health Services (CMHS).

The stigma is compounded for members of racial/ethnic minority groups and residents of rural communities.

CMHS convened two roundtables early in the year with help from the Geriatric Mental Health Foundation and the National

Mental Health Awareness Campaign to find ways to counter stigma. The events convened researchers, advocates, practitioners, media representatives, grant writers, and consumers of mental health services.

Roundtable participants began by identifying types of stigma. For example, older people are often afraid to acknowledge their own mental illness.

Participants also identified barriers, such as a lack of understanding, resources, and competent providers. In response, participants formulated a strategy that centers on a two-part awareness campaign.

One effort would focus on empowering older people with mental illness by educating

them. "One of the ways to effect positive change is to engage more older adults," said Mr. del Vecchio.

A broader effort would use the media to send a positive message about mental health and aging to older people, their adult children, and the public. Recommendations include producing articles for use in senior center newsletters, briefing journalists on mental health and aging issues, and developing public service announcements.

SAMHSA will use the recommendations as the Agency starts planning a national anti-stigma campaign this fall. For more information, contact Paolo del Vecchio at pdelvecc@samhsa.gov.▸

SAMHSA and the U.S. Food and Drug Administration (FDA) recently released public education materials to alert older Americans about the dangers of mixing certain prescription drugs or prescription medications with alcohol, and to highlight the need for vigilance and monitoring of prescription intake by older adults.

Two percent of adults age 55 or older who are admitted for treatment abuse prescription narcotic medications, according to SAMHSA data. The As You Age education materials aim to draw attention to the need to manage prescription medication intake,

as well as the dangers of mixing some medications with alcohol.

The materials include a series of print ads, radio and television public service announcements, a brochure, and a Web site featuring all these resources available for download.

In addition, SAMHSA and the FDA have published a brochure, also titled As You Age, which provides a medication checklist to help older adults keep track of medication types, dose amount, and the proper intervals to take their medication. This brochure also points to the dangers of consuming alcohol with a medication that might have adverse effects due to negative interactions. (For sample safety tips, see SAMHSA News, p. 6.)

The materials were released at a joint press conference together with the Administration on Aging during the May observance of Older Americans Month.

SAMHSA has also established a hotline for drug abuse treatment referral. For help, call the SAMHSA substance abuse treatment 24-hour helpline at 1 (800) 662-HELP or 1 (800) 662-4357. For the names of treatment providers, visit SAMHSA's Web site at www.findtreatment.samhsa.gov.

To obtain materials, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). On the Web, visit www.asyouage. samhsa.gov.

Older Adult's

The number of substance abuse treatment admissions among adults age 55 or older has increased.

In 2001, there were 58,000 treatment admissions age 55 or older-about 3 percent of the 1.7 million treatment

admissions in the Treatment Episode Data Set (TEDS), according to a new report from SAMHSA's Drug and Alcohol Services Information System (DASIS).

TEDS is an annual compilation of data on admissions for substance abuse treatment. Among admissions age 55 or older, alcohol was reported as the primary substance of abuse more frequently than among younger admissions (74 percent vs. 44 percent). Cocaine and marijuana were reported less frequently among older admissions than among younger admissions (5 percent vs. 13 percent and 1 percent vs. 15 percent, respectively).

Nearly two-thirds (64 percent) of older admissions reported abuse of alcohol alone, with no secondary drug abuse, while less

Safety Tips on Medicines & Alcohol for Older Adults

Combining prescriptions or using alcohol with a particular medication may inadvertently cause depression, anxiety, or physical health problems. As You Age... A Guide to Aging, Medicines, and Alcohol, is an informational brochure designed to help reduce this danger. (See SAMHSA News, p. 5.)

Following are some tips from the brochure:

⚫ Know that some medicines do
not mix well with other medications,
including over-the-counter medications
and herbal remedies.

Note changes in body weight. These changes can influence the amount of medicine needed.

Read labels on medications carefully and follow the directions.

Look for pictures or statements that prohibit drinking alcohol while taking a certain medicine.

Talk to a health care professional about all medications, including prescription ones, over-the-counter medicines, and vitamins.

Go through the medicine chest and get rid of expired medicines regularly.

For an electronic copy of the As You Age brochure or other materials, visit SAMHSA's Web site at www.asyouage. samhsa.gov.

than one-quarter (23 percent) of admissions younger than age 55 reported abuse of alcohol alone.

In addition, admissions for age 55 and older were more likely than younger admissions to enter treatment through selfreferral (41 percent vs. 36 percent) and more likely to receive detoxification services than younger admissions (36 percent vs. 25 percent).

Older admissions were less likely than younger admissions to be referred through the criminal justice system (25 percent vs. 35 percent).

For a copy of the DASIS Report, Older Adults in Substance Abuse Treatment: 2001, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). Online, the report is available on the SAMHSA Web site at www.oas.samhsa.gov.

SAMHSA recently launched a multimedia public education effort to raise awareness about the stigma and discrimination associated with mental illness. The campaign includes broadcast and print public service announcements that seek to educate the public that mental illnesses are common, they affect nearly every family across the Nation, and that recovery is possible.

The campaign, Mental Health: It's Part of All Our Lives, is part of a 3-year initiative in eight states: California, Florida, Massachusetts, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin. Featuring people who have experienced mental illnesses, the educational materials emphasize the key contributions that people with mental illnesses make.

Following the campaign in these eight states, SAMHSA will evaluate the effectiveness of the program and then, if effective, launch a national dissemination effort.

"All Americans must understand that effective treatments and supports for mental illnesses exist and that people do recover," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "The fear and stigma that surround mental health problems make it harder for people to access treatment, find employment, or obtain housing. Fortunately, everyone can do something to help reduce stigma."

SAMHSA's National Survey on Drug Use and Health estimates that 17.5 million adults age 18 or older had serious mental illness in 2002. This campaign, part of SAMHSA's Elimination of Barriers Initiative, will promote greater public understanding.

The Web sites include information on the myths and facts about mental health, descriptions of a variety of mental health

disorders, links to referral information
on accessing mental health services, free
materials, information on what people can
do to address stigma and discrimination,
and resources in each of the pilot states.
Specific materials are also in development
targeting employers and high school
administrators.

The Initiative is a collaborative effort among SAMHSA and the eight state mental health authorities, in partnership with mental health consumers, family members, advocates, providers, and a range of national and state mental health organizations. With technical support from the Initiative, the pilot states are undertaking an array of additional strategies such as speakers' bureaus, music festivals, health fairs, and celebrations of recovery.

As part of the Initiative, SAMHSA is evaluating these efforts, along with the educational materials, to determine their effectiveness. When the Initiative ends in 2005, SAMHSA will compile the findings into an evaluation report.

More information about the Mental Health: It's Part of All Our Lives campaign and the Elimination of Barriers Initiative is available on the SAMHSA Web site at www.allmentalhealth.samhsa.gov.

A Spanish version of this Web site will be available soon. For more information about mental health, contact SAMHSA'S National Mental Health Information Center, P.O. Box 42490, Washington, DC 20015. Telephone: 1 (800) 789-2647 or 1 (866) 889-2647 (TTY). ►

SAMHSA will award up to $45 million in competitive grants to states later this year as part of a new Strategic Prevention Framework to advance community-based programs to prevent substance abuse and promote mental health.

The idea is to use findings from public health research along with evidence-based prevention programs to create healthier communities. The effort is aligned with the Healthier US initiative launched last year by Health and Human Services Secretary Tommy G. Thompson at the request of President Bush.

"Our goal is to aid Americans in living healthier, longer lives," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W.

SAMHSA will provide the grants through the state Governors' offices, which will work in partnership with community-level organizations. The goals are to prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking; reduce substance abuse-related problems in communities; and strengthen prevention capacity and infrastructure at the state and community levels.

The Strategic Prevention Framework will also enable states, territories, and the District of Columbia to bring together funding streams from multiple sources to create an approach that cuts across existing programs and systems.

A minimum of 85 percent of the grant award must be allocated to communities for local activities, including data-based decisionmaking and evidence-based prevention efforts. States will use the remaining fundsapproximately 15 percent-to provide leadership and coordination of projects within the states; hire specific staff; conduct a statewide needs assessment; establish and

maintain a state epidemiological workgroup; develop a statewide strategic plan; conduct ongoing monitoring and oversight of the grant project; conduct a state-level evaluation of the project; and provide training and technical assistance to support the project. SAMHSA anticipates funding approximately 20 awards of up to $3 million per year in Fiscal Year 2004 for a period of up to 5 years.

Participating communities will use five steps known to promote youth development, reduce risk-taking behaviors, build assets and resilience, and prevent problem

Implement programs, policies, and
strategies based on what is known
to be effective

Evaluate program effectiveness and

sustain what has worked well.

The success of the Strategic Prevention Framework will be measured by specific outcomes, including abstinence from drug use and alcohol abuse, reduction in substance abuse-related crime, attainment of employment or enrollment in school, increased stability in family and living conditions, increased access to services, and increased social connectedness. Communities will monitor and report outcomes to assess effectiveness and determine if the objectives are being attained. For more information on SAMHSA'S Strategic Prevention Framework, contact the National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; or call 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889. For information online, visit SAMHSA's Web site at www.samhsa.gov.▸