A simple mathematic equation relates a national health emergency that has loomed for years: The rising number of American adults ages 65 and older + an inadequate health workforce = a rising number of adults who will not receive proper care. The problem has become doubly severe with the nation’s shrinking public health infrastructure.
The Institute of Medicine defined a “largely hidden crisis” in a report released Tuesday, stating that between 5.6 million and 8 million older American adults — nearly one in five — have one or more mental health and substance use conditions, including depressive disorders, and dementia-related behavioral and psychiatric symptoms.
With the projected doubling of the aged population by 2030, “The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?” calls for a redesign of the U.S. health system, stating that the magnitude of the problem is too large for isolated changes in federal agencies to address it. Without a significant increase of professionals trained to work with this population, millions of baby boomers will face difficulties seeking mental health and substance use diagnosis and treatment, it says.
“This report is a wake-up call that we need to prepare now or our older population and their extended families will suffer the consequences,” said Dan G. Blazer, chair of the IOM Committee on the Mental Health Workforce for Geriatric Populations.
The report, sponsored by the U.S. Department of Health and Human Services, cites ways in which mental health combined with substance misuse creates higher costs and poorer health outcomes. For instance, older adults with untreated depression are less likely to properly take medications for diabetes, high blood pressure and heart disease, and they are more likely to require repeated costly hospital stays.
According to the IOM, its two decades of research show that mental health and substance use treatment requires:
- Systematic outreach and diagnosis;
- Patient and family education, and self-management support;
- Provider accountability for outcomes; and
- Close follow-up and monitoring to prevent relapse.
“The committee urges Congress to fund the National Health Care Workforce Commission, which was authorized under the Patient Protection and Affordable Care Act to serve as a national resource that focuses on evaluating and meeting the need for health care workers,” the IOM report states.