The aging of America holds profound consequences for the nation, especially when it comes to healthcare, says a report recently released by the Institute of Medicine, and the system isn’t equipped to deal with the substance abuse and mental health needs of the baby boomer population.
Part of the issue is growing ethnic, cultural, and racial diversities, and researchers believe that the healthcare demands and costs that will result from these demographic shifts will be “unprecedented.”
In light of growing concern regarding older adults’ mental health and substance abuse (defied as misuse of, or dependency on alcohol and drugs, whether illicit or legal), the Department of Health and Human Services (HHS), as directed by Congress, asked the Institute of Medicine to conduct a study on the geriatric MH/SU workforce.
The researchers found that the MH/SU needs of older adults are complex and typically occur with other health problems. The problem is that those needs are often inadequately met by the current healthcare system.
Nearly 20% of older adults in the U.S. have at least one, if not more, MH/SU conditions, and this can present challenges for their care, the report says.
“Depressive disorders and dementia-related behavioral and psychiatric symptoms are the most prevalent, but substance abuse is a significant problem as well,” say the researchers.
The challenge lies in the expanding older population, as age alters the way people metabolize alcohol and drugs.
Medications that are commonly prescribed may worsen physical or mental health problems, says the report, and could increase seniors’ risk of a life-threatening overdose.
Additionally, losses that can often occur late in life—such as the death of a spouse—may trigger or worsen depression and could lead to debilitating symptoms, especially as differentiating between severe depression and grief over a significant loss can be difficult.
“Cognitive, functional, and sensory impairments also may complicate detection and diagnosis of MH/SU conditions,” the researchers say.
But the growing healthcare needs may go unmet, as there is little training among the geriatric MH/SU workforce, they continue. Additionally, those who are specialists in MH/SU are generally not trained in geriatrics, and the same is true for geriatric specialists—most don’t have a familiarity with MH/SU. Primary care and other essential providers, they say, are not trained in either area.
“Overall, the number of individuals working in or entering fields related to geriatric MH/SU is disconcertingly small,” the researchers find, adding that the geriatric MH/SU specialists who are equipped to handle complex cases are “in very short supply.”
This may not improve, either, because there aren’t financial incentives to encourage geriatric MH/SU providers to enter and stay in the field, and there’s little support for people who pursue specialization in the field.
National leadership and action is needed to produce an adequate workforce, they conclude.
Access the report at the Institute of Medicine.
Written by Alyssa Gerace