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Support the Comprehensive Geriatric Mental Health Act

An Opinion by Michael B. Friedman, LMSW
First Published in Mental Health News, Summer 2005

Thanks to the vision and leadership of State Senators Nicholas Spano and Thomas Morahan and Assemblymen Peter Rivera and Steven Englebright and others, a Comprehensive Geriatric Mental Health Act (S.4742/A.7672) has been introduced in the New York State Legislature. If passed and signed into law, the Act will lay the groundwork for a long-term effort to confront and meet the mental health needs of older adults in New York State. It will also establish a national model.

Services for Older Adults are Currently Inadequate

The Act arises from recognition that services to older adults with mental disorders are currently inadequate and that neither our state nor our nation is prepared for the mental health challenges that will emerge during the elder boom.

Nationally, the number of older adults will increase from 35 million to 70 million over the next quarter century. Consequently, the number of older adults with mental disorders will increase from 7 million to 14 million.

Critical Shortfalls in Geriatric Mental Health Practice and Policy

The Act draws from The President’s New Freedom Commission’s report on mental health, the New York State Office for the Aging’s 2015 plan, the Office of Mental Health’s most recent five-year plan, and other governmental and academic studies, all of which point to critical shortfalls in geriatric mental health practice and policy including:

The need to increase community supports so as to help older adults with both longstanding and late onset mental disorders to remain in, or return to, the community
The need to improve access to mental health services
The need to improve quality of mental health care both in the community and in institutional settings
The need for more mental health services provided in the home and in community settings such as senior centers, NORCS, and houses of worship where older adults go for help
The need for integration of mental health, health, and aging services
The need to increase the capacity of the system to serve cultural minorities
The need to support family caregivers
The need for public education targeted to older adults, their families, and service providers focused on issues of stigma, ageism, and ignorance about the effectiveness of treatment
The need to build a workforce that is clinically and culturally competent and large enough to respond to the mental health needs of the growing elderly population
The need for more research
The need to develop financing models which support the use of best practices and innovation
The need for enhanced governmental preparation for the mental health challenges of the elder boom

Act Addresses Many Critical Needs

The Comprehensive Geriatric Mental Health Act touches on all of these critical needs. It would not solve all the problems with the wave of a legislative wand, but it would accelerate efforts that have begun in New York State to address geriatric mental health needs over the next decade.

The essential elements of the Act are:

A call for innovation through the establishment of a wide-ranging services demonstration grants program that would be administered by the Office of Mental Health
A new effort to address problems of stigma, ageism, and ignorance about mental illness, the effectiveness of treatment, and where to go for help through the establishment of a public education program targeted specifically to older adults, their families, and their service providers
A workforce development initiative that would focus on building a geriatric mental health workforce for the future by (1) providing incentives to become a geriatric professional— especially for bilingual and bicultural staff, (2) improving education regarding geriatrics in professional schools, (3) providing increased training in best practices, and (4) crafting new roles designed to draw on the strengths of elders themselves, many of whom have the energy and skill to be part of the solution rather than part of the problem.
An initiative to improve quality of care through development of relevant standards of care, the dissemination of information about best practices, and enhanced research
Structural changes in government to facilitate readiness to meet the mental health challenges of the elder boom, including designated senior leadership in the Office of Mental Health and the Office for the Aging, the establishment of an interagency planning group, and requirements regarding comprehensive planning.

Act is Affordable

Implementation of the Act will not be expensive, which is why I refer to it as “The Comprehensive (But Inexpensive) Geriatric Mental Health Act.” Those who have worked on the bill believe that $5 million will enable New York State to take this major leap forward.

In its current form the bill does not include an appropriation. We hope that the Governor will request the needed funds next year.

Let’s join together to set the stage for meeting the mental health needs of older adults and to create a model for our nation. Support The Comprehensive Geriatric Mental Health Act.

(Michael B. Friedman is the Director of the Center for Policy and Advocacy of The Mental Health Associations of New York City and Westchester. He can be reached at center@mhaofnyc.org. The opinions in this article are his own and do not necessarily reflect the positions of The Mental Health Associations.)

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