Addressing the crisis in older adult mental health

Today, several national associations took a very important first step toward improving behavioral healthcare for seniors. We presented a Hill briefing on “Addressing the Crisis in Older Adult Mental Health” as part of Mental Health Awareness Month, hosted by Representatives Grace Napolitano (D-Calif.) and John Katko (R-N.Y.), co-chairs of the House Mental Health Caucus.

The population of seniors is growing rapidly in the United States. By 2030, they will number more than 60 million; by 2060, more than 100 million.  Fully 1 in 5 of these seniors will have one or more behavioral health conditions. Hence, we can predict with great accuracy that by 2060, more than 20 million seniors will be in need of some form of behavioral health services. That number is equivalent to the total number of people receiving specialty behavioral healthcare services today.

Yet, at present, behavioral health services for seniors are at best an afterthought. Little or no focus exists on this issue in our key federal agencies. Clearly, that must change.   

In opening remarks, both Napolitano and Katko highlighted the importance of increasing the Congressional focus on improving mental healthcare for all, and especially for seniors. Both welcomed input via the briefing and beyond regarding next steps the Congress can take in this direction.

Three expert panelists underlined the issue and potential actions that will be needed.

Beginning with a story about his own father, Stephen Bartels, MD, Dartmouth University, demonstrated that few seniors currently have access to the most rudimentary mental health services. To address these deficits, he highlighted four important changes: care integration, including mental health and aging services; home and community based services delivered by peers and community health workers; better use of telehealth; and mobile technology, including  remote sensing.

Jacqueline Gray, PhD, University of North Dakota, spoke to the growing diversity of our senior population and the specialized needs of seniors who also are minorities. She recommended better funding for the Elder Justice Initiative, long-term care ombudsman programs, and Adult Protective Services to address senior abuse; legislation to support increased rural broadband access; and funding for initiatives to eliminate disparities in mental health status and care of older adults through culturally and linguistically competent services.

Brian Kaskie, PhD, recently from the Office of Senator Susan Collins (R-Maine) and currently at the University of Iowa, spoke to the roles that the Congress currently can take in order to begin to effect necessary change in the field. Through its oversight and investigation roles, the Congress can begin to focus light and attention on the problem of senior abuse, inappropriate or negligent care, and wasteful and ineffective use of federal care funds. Such work could begin today; it does not require new legislation.

Participants left the briefing energized and prepared to take the next steps on the Hill to address our growing crisis with senior mental health. As one noted, “We ourselves will become seniors soon. We need to create a better place for all right now.”

This briefing was sponsored by the National Association of County Behavioral Health and Developmental Disability Directors, the National Association for Rural Mental Health, the National Association of Counties, and the National Coalition on Mental Health and Aging.

We wish to thank Napolitano and Katko for their gracious hospitality. We look forward to continued work with both of them on this issue.

As further developments occur, I will report them in future commentaries.