Behavioral health is the promotion of mental health and well-being, the treatment of mental and substance use disorders, and the support of those who experience and/or are in recovery from these conditions. Anyone, regardless of age or ability, can experience a behavioral health condition, such as depression, substance misuse, or suicidal thoughts. Behavioral health problems are not a normal part of aging or of living with a disability, but older people and people with disabilities are less likely to receive mental health treatment. To learn more, visit https://acl.gov/programs/health-wellness/behavioral-health.
Chronic conditions, including depression, are prevalent among older adults. Approximately 80% of older adults have at least one chronic condition, and 50% have two or more. Specific to behavioral health, depression is more common in people who have co-occurring illnesses or who have limited function. Serious mental illness (e.g. schizophrenia, bipolar illness, and major depressive disorder) affects approximately 5% of the population. Data from the National Chronic Disease Self-Management Education Database show that 21% of program participants indicate a diagnosis of anxiety and/or depression. Evidence-based programs such as Healthy IDEAS and PEARLS (see Appendix C for more information) are designed to combat depression experienced by older adults. Additionally, the Wellness Recovery Action Plan (WRAP) program is appropriate for individuals with serious mental illness (see Appendix C for more information).
Additionally, chronic pain is a considerable health challenge facing older adults. Chronic pain is persistent discomfort that lasts for at least three months; it can be caused by a variety of factors, including chronic conditions. In the United States, older and middle-aged adults account for about 80% of those who experience chronic pain. Common chronic conditions that may cause pain include arthritis, diabetes, and cancer, in addition to neuropathic conditions, surgeries, or injuries. Both the Chronic Pain Self-Management Program and evidence-based physical activity programs can be important tools for pain management (see Appendix C for more information). To view an issue brief on implementing evidence-based programs to address chronic pain, visit https://www.ncoa.org/resources/issue-brief-implementing-evidence-based-….
Evidence-based chronic disease self-management education (CDSME) programs can help mitigate chronic disease burden by empowering participants to better manage their conditions. The acronym, CDSME, is being used in this announcement as an umbrella term for community-based education programs specifically designed to enhance patient self- management of chronic conditions (including behavioral health concerns and chronic pain). These programs focus on building multiple health behaviors and generalizable skills such as goal setting, decision making, problem solving, and self-monitoring, and are proven to maintain or improve health outcomes of older adults with chronic conditions. Similarly, a self-management support program is a community-based, behavioral change intervention that is proven to increase one or more skills or behaviors relevant to chronic disease self-management such as physical activity or medication management.
AoA has supported CDSME and other evidence-based health promotion programs for many years through grants, as well as collaborations on various federal initiatives. For example, Prevention and Public Health Fund initiatives in 2018 and 2019 supported 21 CDSME grantees. Additionally, Older Americans Act Title III-D funding supports a broader portfolio of evidence-based disease prevention and health promotion activities. For more information about ACL’s CDSME Program, including profiles of current grantees, please visit: https://www.acl.gov/programs/health-wellness/chronic-disease-self-manag….
This funding opportunity is designed for applicants to propose how they will develop capacity for, deliver, and sustain evidence-based self-management education and support programs that address behavioral health and/or chronic pain among older adults and adults with disabilities.
Goal 1: Through robust partnerships, develop a result-based, comprehensive strategy for addressing behavioral health and/or chronic pain among older adults and adults with disabilities living in your community.
Goal 2: Significantly increase the number of older adults and adults with disabilities who participate in evidence-based self-management education and/or self-management support programs to empower them to better manage these chronic condition(s), while concurrently pursuing the sustainability of these programs beyond the end of the grant period.
Please refer to Appendix A (Glossary of Terms) for definitions of CDSME and self- management support programs. Applicants for this funding opportunity must propose to deliver one or more CDSME and/or self-management support programs. Programs proposed must be on the list of pre-approved interventions found in Appendices B and C. Applications that include programs not found on the list of pre-approved interventions in Appendices B and C will be administratively eliminated and will not be reviewed.
 “Behavioral Health.” Administration for Community Living, July 2019, https://acl.gov/programs/health-wellness/behavioral-health.
 “Depression Is Not a Normal Part of Growing Older” Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Jan. 2017, www.cdc.gov/aging/mentalhealth/depression.htm.
 “Older Adults Living with Serious Mental Illness.” Substance Abuse and Mental Health Services Administration, May 2019, https://store.samhsa.gov/product/Older-Adults-Living-with-Serious-Menta….
 “National Chronic Disease Self-Management Education Resource Center: Program Highlights and Charts.” National Council on Aging, Jan. 2019, www.ncoa.org/resources/national-chronic-disease-self-management-educati….
 “Issue Brief: Implementing Evidence-Based Programs to Address Chronic Pain.” National Council on Aging, 2018, www.ncoa.org/resources/issue-brief-implementing-evidence-based-programs….
 Brady, Teresa. “Strategies to Support Self-Management in Osteoarthritis.” AJN, American Journal of Nursing, vol. 112, no. 3, 2012, pp. 54–60., doi:10.1097/01.naj.0000412653.56291.ab.