Mental health amongst the elderly going undiagnosed

Older adults in America are facing a crisis. The Centers for Disease Control and Prevention estimates that 20% of adults over the age of 55 are suffering from mental health issues. These disorders include anxiety, depression, and substance use disorder. Millions more likely go undiagnosed, as the National Academy of Medicine. has found that less than 40% of older adults with mental and/or substance use disorders receive treatment. The ongoing opioid crisis has only contributed to this trend, and it is estimated that 5.7 million adults over the age of 50 will require treatment for a substance use disorder this year. Medicare enrollment is expected to skyrocket in the coming years, with 80 million Americans projected to be on the program by 2030. This growth will further burden an already overtaxed system that is failing to provide mental heath services to its beneficiaries.

At a time when Medicare-eligible individuals are suffering from mental health challenges more than ever, we should implement an “all hands on deck” approach, with access to all mental health providers being expanded. However, Medicare does not reimburse for talk therapy services provided by mental health counselors or marriage and family therapists. These two professions make up approximately 40% of the licensed behavioral health workforce in the United States. They are covered by all other insurance providers, both public and private, aside from Medicare. With these two professions shut out of the largest insurer in the country, Medicare beneficiaries do not have sufficient access to mental health treatment.

Mental health counselors and marriage and family therapists are qualified to provide counseling services and are already an integral part of the mental health care delivery system in the United States. They are required to obtain a minimum of a master’s degree, perform two years of postgraduate clinical supervised experience, and pass a national exam to practice independently. These requirements mirror those of current Medicare mental health providers, such as licensed clinical social workers. Mental health counselors and marriage and family therapists provide services in all settings, ranging from private practice to hospitals and everything in between. The fact that these providers are currently covered by all other insurance sources and work in a variety of settings means that people can access their services up until they go onto Medicare, at which point access to these providers is lost. Medicare beneficiaries across the country have had to discontinue treatment with a mental health counselor or marriage and family therapist they have been seeing for years through no fault or choice of their own.