Janet C. Frank, DrPH, MS, is an affiliate at the UCLA Center for Health Policy Research and an adjunct associate professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Her current responsibilities include working with the California Community College Health Workforce Initiative (HWI) and with the Research Subcommittee of the California Master Plan on Aging.

From 1990 to 2013, Frank served as assistant director of academic programs in the UCLA Multicampus Program in Geriatric Medicine and Gerontology at the Geffen School of Medicine at UCLA where she led projects in geriatric workforce development. This included projects for the California Geriatric Education Center and the National Coordinating Center for the Research Centers for Minority Aging Research.

In 2013, Frank retired from her full-time role in geriatric medicine and joined the UCLA Center for Health Policy Research on a part-time basis. In her role as affiliate at the UCLA Center for Health Policy Research, she participated in a systematic review of clinical preventive services for older adults, and the Healthy Aging Prevention Partnership Initiative. Most recently she directed the California Mental Health and Older Adult System of Care study, and a related project on the behavioral health workforce. Previous work through the Center also involved serving as a special assistant to the director of the National Coordinating and Evaluation Center for the NIH Diversity Education Consortium.

Frank received her master's degree in gerontology from the University of Southern California and her doctorate in public health from the UCLA Fielding School of Public Health. 

Discover, Connect:

Explore

California’s Behavioral Health Services Workforce Is Inadequate for Older Adults
Policy Brief
Policy Brief

California’s Behavioral Health Services Workforce Is Inadequate for Older Adults

​The Workforce, Education and Training component of California’s Mental Health Services Act, which passed in 2004, has infused resources into the public mental health system. However, these resources have not kept pace with an existing behavioral health workforce shortage crisis, the rapid growth of an aging population, and the historical lack of geriatric training in higher education for the helping professions. This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California. 

A series of recommendations to improve workforce preparation and distribution are presented to specific audiences: state policy makers and administrators; educational institutions, accrediting bodies, and licensing boards; and county mental health/behavioral health departments and their contracted providers.

Publication:

Mental Health Services for Older Adults: Creating a System That Tells the Story
Policy Brief
Policy Brief

Mental Health Services for Older Adults: Creating a System That Tells the Story

In 2004, voters in California approved Proposition 63 for passage of the Mental Health Services Act (MHSA). From that time until 2014, over $13 billion in the state’s tax revenue was allocated for public mental health services. There is very little information available to answer critical questions such as these: How much of this amount was spent in the interests of older adult mental health? What benefits were gained from services delivered to older adults? This policy brief promotes recommendations for specific age-relevant indicator utilization and for an expanded system of uniform and transparent data for all types of MHSA-funded programs. These two policy directions are necessary in order to document the older adult mental health care services provided and to track outcomes at the state level for MHSA programs. A third recommendation centers on assuring that the mental health workforce is prepared to utilize and report age-relevant data indicators.

This policy brief is part of a six-county study of public mental health services for older adults funded by the MHSA. This is the first study to assess whether MHSA-funded services meet the complex needs and address the recovery goals of older adults with mental illness by supporting an Older Adult System of Care (OASOC). 

Publication: 

Promising Older Adult Mental Health Programs
Fact Sheet
Fact Sheet

Promising Older Adult Mental Health Programs

This fact sheet and the accompanying compendium provide information about 25 promising older adult mental health programs that were identified through the California Mental Health Older Adult System of Care Project. The two-year study assessed older adult mental health care service delivery in six counties through key informant interviews with administrators, county-contracted providers, and consumers of county mental health services. Specifically, stakeholders were interviewed about their views on facilitators for implementing an integrated and comprehensive system of mental health care for older adults and also on strategies for overcoming barriers to implementation. Through this process, the interviewees described mental health programs and services that they believed were beneficial for older adults based on firsthand experience. These older adult mental health programs are deemed promising in that, per the dictionary definition of that word, they "are likely to succeed or to yield good results" and also may be of interest to other counties across the state.
 
Publication:

 

California's Public Mental Health Services: How Are Older Adults Being Served?
Fact Sheet
Fact Sheet

California's Public Mental Health Services: How Are Older Adults Being Served?

This fact sheet presents information from a six-county study of public mental health services for older adults funded by the Mental Health Services Act (MHSA) of 2004.1 This is the first study to assess whether MHSA-funded services meet the complex needs and address the recovery goals of older adults with mental illness by supporting an Older Adult System of Care (OASOC).

Publication:

California’s Behavioral Health Services Workforce Is Inadequate for Older Adults
Policy Brief
Policy Brief

California’s Behavioral Health Services Workforce Is Inadequate for Older Adults

​The Workforce, Education and Training component of California’s Mental Health Services Act, which passed in 2004, has infused resources into the public mental health system. However, these resources have not kept pace with an existing behavioral health workforce shortage crisis, the rapid growth of an aging population, and the historical lack of geriatric training in higher education for the helping professions. This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California. 

A series of recommendations to improve workforce preparation and distribution are presented to specific audiences: state policy makers and administrators; educational institutions, accrediting bodies, and licensing boards; and county mental health/behavioral health departments and their contracted providers.

Publication:

View All Publications

Mental Health Services for Older Adults: Creating a System That Tells the Story
Policy Brief
Policy Brief

Mental Health Services for Older Adults: Creating a System That Tells the Story

In 2004, voters in California approved Proposition 63 for passage of the Mental Health Services Act (MHSA). From that time until 2014, over $13 billion in the state’s tax revenue was allocated for public mental health services. There is very little information available to answer critical questions such as these: How much of this amount was spent in the interests of older adult mental health? What benefits were gained from services delivered to older adults? This policy brief promotes recommendations for specific age-relevant indicator utilization and for an expanded system of uniform and transparent data for all types of MHSA-funded programs. These two policy directions are necessary in order to document the older adult mental health care services provided and to track outcomes at the state level for MHSA programs. A third recommendation centers on assuring that the mental health workforce is prepared to utilize and report age-relevant data indicators.

This policy brief is part of a six-county study of public mental health services for older adults funded by the MHSA. This is the first study to assess whether MHSA-funded services meet the complex needs and address the recovery goals of older adults with mental illness by supporting an Older Adult System of Care (OASOC). 

Publication: 

Promising Older Adult Mental Health Programs
Fact Sheet
Fact Sheet

Promising Older Adult Mental Health Programs

This fact sheet and the accompanying compendium provide information about 25 promising older adult mental health programs that were identified through the California Mental Health Older Adult System of Care Project. The two-year study assessed older adult mental health care service delivery in six counties through key informant interviews with administrators, county-contracted providers, and consumers of county mental health services. Specifically, stakeholders were interviewed about their views on facilitators for implementing an integrated and comprehensive system of mental health care for older adults and also on strategies for overcoming barriers to implementation. Through this process, the interviewees described mental health programs and services that they believed were beneficial for older adults based on firsthand experience. These older adult mental health programs are deemed promising in that, per the dictionary definition of that word, they "are likely to succeed or to yield good results" and also may be of interest to other counties across the state.
 
Publication:

 

Qandaimage
Ask the Expert

Three Questions with Janet Frank on Behavioral Health

 

Ask the Expert Janet

Janet Frank is a faculty associate and lead author of a new study on the need for a more robust and well-trained workforce to serve the behavioral health needs of California’s older adults. In this brief interview, she discusses the need for geriatric behavioral health training and models that have addressed the recruitment and retention for the public behavioral health workforce that serves California’s older adults. 

 
Q: Explain a little more why behavioral health training needs to be specialized for older adult behavioral health services? 

There are several important differences about serving older adults with behavioral health needs. First, most older adults, about 80 percent, have one or more chronic medical conditions, along with their behavioral health issues. This makes their care more complicated. Clinicians need to be able to take an integrated approach to their care and understand the challenges of providing services to people with complex medical needs. One example of this is managing medications. Older adults metabolize medications more slowly than younger people, so they stay in their systems longer. So the geriatric approach to medication dosage is “start low and go slow” to avoid toxicity and other adverse events associated with medication mismanagement.   

 
Q: Your study reports that the public behavioral health workforce is understaffed and inadequately trained for the challenges of caring for older adults. What models or ideas address these issues? 

There are a number of good models that counties have developed to address the specialized needs of older adult behavioral health care. In Los Angeles County, the Geriatric Evaluation Networks Encompassing Services Intervention Support (GENESIS) Program deploys an interprofessional geriatric team to provide assessment and treatment to older adults. GENESIS includes geriatric psychiatry residents from UCLA for a six-month rotation. 

Another great training model is in San Diego County. The Geriatric Certificate Program is an intensive six-month certificate training with a culminating project and continuing education with the academy based at San Diego State University. There is an application process and selection for the positions for clinician case managers who will be clinic-based. This is believed to be the only such intensive education for persons who focus on service to older adults. This is at the level of a college course and provides an incentivized job role to account for older adult case load. 

In Monterey County, the Senior Peer Counseling Program (SPC) provides no-cost mental health intervention and emotional support to older adults suffering from depression, anxiety, grief, loss, adjustment to chronic illness, and other stressors that can occur in the later life. Peer counselors, trained and supervised by mental health professionals, provide short-term one-on-one counseling that may be home-based, office-based, or at long term-care facilities. 
 

Q: You talk about many problems in training and retaining workers in behavioral health. Is there any way to make geriatrics training sexier, so more people will go into the field? 

Since colleges and universities typically do not require gerontology or geriatrics courses within the “helping professions” that comprise the behavioral health workforce (e.g., psychiatrists, psychologists, social workers, counselors), there is not exposure to this content unless the student takes elective courses. Only between 1 and 4 percent of behavioral health professional take geriatrics electives during their graduate work. Due to ageism, the cost and time for advanced training and lack of programmatic and salary incentives, there is not much “up side” for going into geriatrics, and specifically geriatric behavioral health. 

I’m afraid there isn’t a way to make geriatrics “sexier,” however we can urge our state planners and policy makers to set up course requirements and hiring/salary incentive programs to encourage people to choose this specialization. After all, 1 in 5 Californians will be older adults by the next decade ― we are already late in our preparation to serve their needs.   

 

View All Blogs

Video

Improving California’s Behavioral Health Workforce for Older Adults

One in five Californians will be an older adult by 2030, yet gaps and deficits in the state’s geriatric mental health care workforce still exist.

In our January seminar, Faculty Associate Janet Frank and Research Scientist Kathryn Kietzman share recommendations from their new study on how state policymakers, educational institutions, and county mental health/behavioral health departments and their contracted providers can help improve this workforce and ensure that mental health care training that addresses the unique needs of older adults is a priority instead of an afterthought.

View all Training

Online & In-Person

Dr. Steven P. Wallace Memorial

View all Events

Online & In-Person

Improving California’s Behavioral Health Workforce for Older Adults

Online & In-Person

Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?