Mental Health Care and Older Adults: Facts and Policy Recommendations

Facts about Barriers to Mental Health Care for Older Americans

Older adults in our country face significant access barriers to high quality mental health care.

Researchers estimate that up to 63% of older adults with a mental disorder do not receive the services they need.

In fact, studies suggest that only 3% of older adults report seeing mental and behavioral health professionals for treatment.

Many older adults do not openly identify their problems as "mental health concerns" and may instead present with a physical complaint to their medical professional.

Data suggests that approximately 70% of all primary care visits are driven by psychological factors (e.g., panic, generalized anxiety, major depression, somatization, stress, and adjustment disorders).

Research indicates that many health professionals are not adequately trained to assess and treat behaviorally based and psychosocial problems.

In fact, ž of primary care patients with depression do not receive appropriate care.

Symptoms of depression in older Americans can be overlooked and untreated because they often coincide with other medical illnesses or life events that occur as people age (e.g., loss of loved ones).

Recommendations for Improving Access to Mental Health Care for Older Americans

Because older adults may be more likely to utilize primary care services, it is imperative that appropriate training be provided to physicians and other healthcare professionals to identify mental health concerns.

It is important that these healthcare professionals be encouraged to collaborate with, and refer to, other health professionals who have expertise in mental and behavioral concerns.

Providers from various disciplines who serve the older adult community must work together as an interdisciplinary health care team to provide a collaborative model of care for older adults.

In order to meet the mental health needs of older adults, it is essential that there be parity for mental health services under Medicare. Currently, Medicare only reimburses for 50% of outpatient mental health care as compared to 80% for medical care.

Medicare limits need to be extended for inpatient mental health coverage to care for older adults with persistent mental disorders. Currently, Medicare only allows for 190 days of psychiatric hospitalization in one's lifetime.

Medicaid coverage needs to be expanded to include older adults as a "categorically needy" group. Currently over half of Medicaid-covered older persons are classified as optional. In addition, the 50% Medicare co-payment is fully reimbursed by Medicaid in a very limited number of states.

Efforts need to be made to reduce the stigma that is often associated with mental disorders and treatment.

The geriatric mental health workforce must be expanded to accommodate the growing number of older adults in need of services.

Increased funding and support is necessary for basic and applied behavioral research and the incorporation of empirically-based interventions into clinical practice with older persons.

American Psychological Association, July 2003