As Americans grow older, they face more mental health challenges. An estimated 20% of Americans 55 and older are suffering from mental health concerns. Among the primary issues this age group faces are isolation, comorbid physical conditions and high suicide rates, particularly among older men. Less than half of older adults with mental health and substance use disorders receive treatment. But these challenges don’t just affect older Americans — they affect their caregivers as well.
Unique challenges associated with aging
Chief among the mental health concerns associated with growing older is isolation, which can be exacerbated by the loss of a spouse, ever-shrinking social circles and mobility limitations. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of U.S. adults report feeling lonely (35% of adults aged 45 and older and 43% of adults aged 60 and older). Feelings of isolation often lead to depression and anxiety, impacting overall well-being.
Older adults are also frequently dealing with multiple chronic conditions such as diabetes, heart disease and arthritis, which can compound mental health issues. These physical ailments can lead to decreased mobility and independence, further contributing to feelings of helplessness, loneliness and depression.
Older men are particularly vulnerable. Men ages 85 and older have the highest rate of suicide of any age group at 55.7 suicides per 100,000 people. There are several factors contributing to this: loss of significant relationships, chronic pain, a lack of social support, reliance on caregivers and loss of independence, and the stigma associated with seeking mental health care.
“In our aging society, improving the mental health of older adults and their caregivers should be a national priority.”
Katherine Wooten – Senior Director & expert in geriatric care
Impact on caregivers
The mental health challenges faced by older adults do not exist in isolation. They affect entire families. Adult children and other family members who serve as caregivers often experience pressure, worry and burnout. A survey of family caregivers found that 57% reported high levels of stress, anxiety and/or depression. The burdens of caregiving can lead to neglect of their own health, strained relationships and financial difficulties. This stress can also trickle down to affect other family members, creating a cycle of mental health challenges within families.
The role of Medicare in mental health services
Given the growing recognition of mental health as a critical component of overall health, there is a pressing need for Medicare and Medicare Advantage (MA) plans to integrate more comprehensive mental health services. The Mental Health Parity Act, which mandates that insurance plans provide equal coverage for mental and physical health conditions, is a crucial step in ensuring that older adults and their caregivers have access to the necessary resources.
Currently, Medicare provides coverage for some mental health services, but there are limitations. For instance, Medicare Part A covers inpatient mental health care, while Part B covers outpatient services, including visits to psychiatrists and psychologists. However, the scope and extent of coverage can vary, and many beneficiaries may not be aware of the services available to them. Moreover, not all mental health services are covered equally, which can lead to gaps in care.
For mental health parity to be fully realized in Medicare and MA plans, there must be an emphasis on integrating mental health services into primary and specialty care settings where many older Americans are routed to behavioral health care. This integration would help in early identification and treatment of mental health issues, reducing the stigma associated with seeking help, and ensuring that mental health care is treated with the same importance as physical health care.
In our aging society, improving the mental health of older adults and their caregivers should be a national priority. Adopting a comprehensive approach that includes the integration of mental health services into Medicare and MA plans, and increasing awareness and accessibility of these services, is the key to ensuring a healthier, happier and more supportive future for us all.
Katherine Wooten, LCSW, BCBA, CCM is a senior director and expert in geriatric care at Lucet, The Behavioral Health Optimization Company.
