Mental Health Services

Older adults' mental health needs are identifiable and treatable. Effective interventions include individual and group psychotherapy; psychoactive medications; support groups, including support for family caregivers; hospitalization; electric shock therapy; family counseling; pastoral counseling; special therapies such as art, pet, and music therapies; community support services; and stress management and other skills training. Services are provided in a variety of settings, including, but not limited to, private clinical practices, community mental health centers, adult day care, group homes, foster care, nursing homes, general hospitals, psychiatric hospitals, and state hospitals.

There is no comprehensive service system for older adults with mental disorders. Older adults needing mental health services must depend on multiple care systems that are not well integrated to meet their complex needs: the aging network, the health care system, and the mental health system. Mental health interventions may be provided through one or any combination of these systems, through both the public and the private sector. Public sector mental health services are historically state-directed, although funding through Medicare, Medicaid, and block grants has increased the federal role since the 1960s. Older adult mental health programs and services vary in level and type across states. Some states have aging-specific services, while others do not specialize. State and nationwide mental health and aging coalitions, a phenomenon of the 1990s, promise improved coordination of care.

The primary care physician is a commonly utilized point of entry and treatment resource for older adults experiencing mental health problems, especially of the late-onset type. This is explained in part by the fact that mental health symptoms of older adults are likely to be linked to somatic symptoms, such as weight loss, insomnia, or shortness of breath. It is also explained in part by the generations-old stigma associated with mental health treatment. Primary care practitioners are in a good position to treat interrelated physical and mental health conditions, but mental health-related training and experience of health professionals vary widely.