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Advocacy > Be An Advocate
Testimony at New York City Council Hearing on Geriatric Mental Health - December 19, 2006
My name is Michael Friedman, and I am the Chairperson of the Geriatric Mental Health Alliance
of New York—an advocacy group with approximately 2,000 members. I very much appreciate
the opportunity to speak to you today about the mental health challenges of the coming elder
boom and to thank you in person for the funding the City Council has provided for geriatric
mental health over the past two years. I urge you to continue this funding.
I am appearing today with Jessica Walker and Michael Polenberg, and we have coordinated our
testimony. I will provide a very brief overview to give a sense of the scope and the nature of the
issues we need to confront. I have also distributed several brief articles that I have written and
two copies of our comprehensive briefing book, which is available on our web site. We would
be glad to provide more if you want them. And I have given you a document entitled “Meeting
The Mental Health Challenges of the Elder Boom”, which is on two-sides of one page for easy
reference.
- My message today is quite simple. The coming elder boom creates great challenges for the
mental health system as well as for the health, aging services, and social security systems.
- Unfortunately, the importance of mental health is rarely acknowledged despite the fact if you
ask older adults what they fear most they will probably say “losing my mind.” Mental health
is absolutely central to living well in old age.
- You know, of course, that the number of older adults (65+) in the U.S. will double over the
next quarter century from 35 million to 70 million. In NYC the number will increase by 2/3
from .9 to 1.5 million.
- Not only will the number grow, the proportion of older adults will increase from about 13%
to about 20% of the total population while the proportion of working age adults will decline
5%. This is what drives concerns about the viability of the Social Security system. It also
drives concerns about who will be the health and human services workforce of the future.
- In addition, the proportion of older adults from minority cultures will increase from 16% to
25%. Our service systems are of very limited cultural competence now. This will only get
worse in the future unless we take aggressive steps soon.
- 20 % of older adults have a mental disorder. Consequently, the number of older adults with
mental illnesses in the U.S. will double from 7 million to 14 million and will increase more
than 2/3 in NYC from about 180,000 to 300,000.
- Please note that 80% of older adults do not have a mental disorder. Contrary to our society’s
ageist myths, mental illness is not a normal part of aging.
- But mental disorders are a serious problem, resulting in personal misery, social isolation, and
high suicide rates. Mental disorders also contribute to unnecessary placement in nursing
homes and to complications of chronic conditions that drive the costs of health care up. A
majority of the most costly Medicaid cases are people with co-occurring physical, mental,
and/or substance abuse problems.
- Sadly, only 20-25% of older adults with mental disorders receive services from mental health
professionals. In New York City approximately 43,000 of 180,000 are served by the public
and private mental health sectors combined. An additional 45,000 are served in primary
healthcare.
- But often they are not served well. Mental health services in both community settings and
institutions such as adult and nursing homes are of “uneven” quality. E.g. only 12.7% of
people with mental illness treated by primary care physicians receive “minimally adequate
care.” For mental professionals it is 48.3%.
- Under-service and uneven quality reflect the vast shortage of clinically and culturally
competent mental health, health, and aging professionals.
- These are all very big problems that are difficult to tackle. But we are pleased to report that
there has been some progress.
- NYS has enacted the first Geriatric Mental Health Act in the nation. It called for the creation
of an Interagency Geriatric Mental Health Planning Council and for the establishment of a
services demonstrations grants program with $2 million for the first year.
- In NYC, thanks to visionary leadership, DFTA and DOHMH have been working together
and have organized an important initiative to identify and arrange treatment for older adults
who are depressed. They have taken other positive steps as well.
- The City Council’s funding initiative is very important and demonstrates your understanding
of the growing geriatric mental health needs.
- These progressive developments make us optimistic that New York can lead the nation in
preparing to meet the mental health challenges of the elder boom. We look forward to
working with you to confront these challenges.
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