The United States is no longer a nation in which children and youth are the largest population group. Currently, one in five Americans is over age 55 and 13% of the total population is now over age 65 (Herr, 1999; Seibyl, Rosenheck, Coewel, & Medak, 2000). Although most of those age 65 and over are active and functioning well, chronological age can be considered a risk factor, whether or not any other risk factors are present in their lives (e.g., disability, minority group membership). The prevalence of psychological distress among aging populations increases with age. Gerontological research of mental morbidity indicates increased rates and various types of psychological distress, including depression, substance abuse, psychiatric problems, suicidal ideation, and generalized vulnerability to stresses of aging (Lands, 1997). According to Palmore (1999), most rehabilitation programs for persons with disabilities tend to discriminate against elders. One reasonable explanation for this bias is that rehabilitation services are tied to employment outcomes, and most aging and elderly persons are assumed to be retired or approaching retirement and therefore ineligible for services (Atchley, 1997). Moreover, physicians, social workers, and professionals who serve persons with disabilities do not usually refer aging and elderly persons with disabilities for rehabilitation and occupational training programs (Palmore, 1999). Palmore referred to the lack of referral of aging and elderly persons for rehabilitation services as ageism. This form of discrimination against elderly persons results in their having less access to American society than do younger persons with disabilities.
Growing older in a changing, mobile, and technological society imposes heavy demands for adaptation which many older individuals are ill prepared to meet. Because of the growing number of people who are at or beyond conventionally defined retirement ages, and because of the growing understanding of the effects of ageism and other risk factors for these populations, rehabilitation counselors, mental health practitioners, and social workers are recognizing the need to provide counseling and related services, as well as to develop new therapeutic techniques to work with this population.
This article addresses implications of collaboration between rehabilitation counselors, mental health practitioners, and social workers in assisting aging populations with disabilities. In addition to an overview for collaboration between rehabilitation counseling, mental health, and social work, information is presented on casework as a common denominator, the basis for integrative and collaborative policy, and strategies and implications for functional integration in rehabilitation counseling. Collaboration between vocational rehabilitation, social work, and mental health for aging populations may defend against organizational barriers in service provision, and significantly contribute to the goals of employment, mental health stability, and social well being.
Overview for Collaboration
Human service professionals such as vocational rehabilitation counselors, mental health practitioners, and social workers provide specific services to aging populations with disabilities, dysfunctions, and/or interruptions in daily life activities. Each of these providers plays an integral role in the psychosocial adjustment of aging persons with disabilities who receive multiple services, experience family dysfunction, or require therapeutic services. For example, social work is centered on the identification of individual and environmental strength, and based on the belief that services should focus on promoting individual capacities and enhancing the environment in which these can best be mobilized and applied (Loewenberg, Dolgoff, & Harrington, 2000). Chachkes (1999) indicated that "social work values fit easily with the goals of rehabilitation, which are to facilitate maximum functioning and quality of life, encouraging independence and patient involvement" (p. …