The 4Ms of an age-friendly health system in behavioral health: pilot test of an educational framework

This pilot test of the 4Ms-Behavioral Health (4Ms-BH) training program was designed to assess knowledge gains, clinical behavior change, and acceptability among mental health clinicians and compile lessons to guide widespread implementation of the framework. The ultimate future goal is to improve care for older adults by expanding the 4Ms framework for behavioral health providers.

Fifteen mental health clinicians from Community Mental Health Centers in three states completed eight hours of live session training over six months: one three-hour introduction followed by five monthly application sessions. Clinicians completed knowledge and clinical behavior measures before and after training, along with follow-up discussion regarding acceptability and sustainability.

Although knowledge gains were not significant in the overall 4Ms knowledge assessment, knowledge in the Medication and Mobility domains improved at 17% and 15%, respectively. Participants completing the program demonstrated an increased frequency of clinical behaviors pertinent to older adult care with large effect sizes in each of the 4Ms assessment and action activities from pre-training to post-training (Cohen's d range = 0.82 - 1.66, p ≤ 0.01).

The 4Ms-BH framework was well-received by participants, who demonstrated some significant knowledge gains and clinical behavior change. These pilot data suggest that this framework has strong potential to effectively train mental health clinicians with little geriatric training.