Mental Health Services

The mental health needs of older Americans are a matter of increasing attention, a fact reflected in the growing number of services available since 1975. Even so, the mental health needs of older adults are poorly understood, mental health services are fragmented, and existing services are underutilized. Consequently the older population is especially vulnerable to preventable outcomes: related physical health problems, social isolation, risk of alcohol or medication misuse or abuse, a high rate of suicide, and a reduced quality of life.

As in any discussion about the older population, it is first important to recognize the wide age range and considerable diversity of the category of people we call "old." Conventionally, age sixty or sixty-five-plus has been used to mark entry into old age or older adulthood. A 1999 report on mental health and aging from the U.S. Surgeon General classifies "older adults" as the population age fifty-five and older, a categorization that includes centenarians, their children, and many of their grandchildren. Significant variability in physical health and mental health exists within and across age groups from the young old to the oldest old. The older population also is increasingly ethnically diverse; the minority share of the older population is projected to grow significantly, and the Latino population is expected to outnumber the African-American population by 2010 (Kart and Kinney). The heterogeneity of the older population has significant implications for the way mental health services are planned and implemented.