Positive and healthy aging
By U.S. Sen. Susan Collins
(R-Maine)
Maine has one of the highest proportions of older residents, ranking seventh among all the states. By the year 2025, one in five, or 21.4 percent of Maine’s population, will be over the age of 65. Given the make-up of our state, it is clear why the health and wellbeing of older Mainers are particularly important to us.
What is often overlooked, however, is the prevalence of mental illness among our nation’s elderly citizens. Studies have shown that more than one in five Americans aged 65 and older experience mental illness, and that as many as 80 percent of elderly persons in nursing homes suffer from some kind of mental impairment. Particularly disturbing is the fact that the mental health needs of older Americans are often overlooked or not recognized because of the mistaken belief that they are a normal part of aging and therefore cannot be treated.
While older Americans experience the full range of mental disorders, the most prevalent mental illness afflicting older people is depression. Ironically, while recent advances have made depression an eminently treatable illness, only a minority of elderly depressed persons are receiving adequate treatment. Unfortunately, the vast majority of depressed elderly persons don’t seek help. Many simply accept their feelings of profound sadness and do not realize that they are clinically depressed.
Moreover, those who do seek help are often underdiagnosed or misdiagnosed, leading the National Institute of Mental Health to estimate that 60 percent of older Americans with depression are not receiving the mental health care that they need. Failure to treat this illness leads to poorer health outcomes for other medical conditions, higher rates of institutionalization, and increased health care costs.
Fortunately, important research is developing innovative approaches to improve the delivery of mental health care for older adults by integrating it into primary care settings. This research demonstrates that older adults are more likely to receive appropriate mental health care if there is a mental health professional on the primary care team, rather than simply referring them to a mental health specialist outside the primary care setting. Multiple appointments with multiple providers in multiple settings simply don’t work for older patients who often must also cope with concurrent chronic illnesses, mobility problems, and limited transportation options. The research also shows that there is less stigma associated with psychiatric services when they are integrated into general medical care.
To build upon this important research and to ensure that older Americans have access to the quality mental health care they deserve, I have introduced legislation, along with my colleague Sen. Barbara Mikulski (D-MD), that would authorize the Substance Abuse and Mental Health Services Administration to fund demonstration projects to support integration of mental health services into primary care settings. The Positive Aging Act of 2011 would also support grants for community-based mental health treatment outreach teams to improve older Americans’ access to mental health services. To ensure that these geriatric mental health programs have appropriate attention and oversight, it would mandate the designation of a Deputy Director for Older Adult Mental Health Services in the Center for Mental Health Services, and it would also include representatives of older Americans or their families and geriatric mental health professionals on the Advisory Council for the Center for Mental Health Services.
Our legislation has been endorsed by the Alzheimer’s Association, the American Geriatrics Society, the American Association for Geriatric Psychiatry, the American Psychological Association, the American Psychiatric Association, and the National Alliance on Mental Illness.
We are fortunate today to have a variety of effective treatments to address the mental health needs of American seniors. The Positive Aging Act will help to ensure that older Americans have access to these important services.
