| Learning Objective #1: Describe the mental health diagnoses, types of mental health services, and sociodemographic characteristics of older adult Medicare beneficiaries receiving mental health services from advanced practice nurses | |||
| Learning Objective #2: Describe the similarities and differences in the sociodemographic and clinical factors of aged Medicare beneficiaries receiving mental health services from advanced practice nurses, psychiatrists, psychologists, social workers, physician assistants, and primary care physicians |
The mental health needs of the aged American population are a complex public health problem. The dramatic shift upward in the number of older adults alone is a serious health policy challenge. Rising longevity and the fact that the incidences of complicated and expensive physical, psychological and social disabilities increase with age magnify this challenge. The number and training of the health care workforce attempting to meet these challenges is poorly documented. Workforce data is deficient and a significant barrier to developing realistic and effective policies to provide mental health care services to older adults. The purpose of this study was to describe the mental health service utilization by older adults and provide a description of the providers delivering these services, specifically advanced practice nurses. Of the more than 2 million individuals enrolled as Medicare beneficiaries in a 5% national sample, 185,403 had a primary mental health disorder diagnosis and met inclusion criteria for this study. The study found treated prevalence of mental illness in older adults was 9% with estimated prevalence rates of 18%. Older adults with mental illness have complex psychiatric presentations, which may be associated with the progression of aging. Diagnosis and service use was associated with racial disparities. A critical shortage of providers was documented by this study. Advanced practice nurses were found to be providing for the complex mental health needs of the poorest and the most under served oldest adults. An adequate supply of mental health providers whose skills are appropriately utilized is essential for cost-effective mental health services. Knowledge of the complex mental health needs of older adults and the critical labor shortage should propel mental health workforce issues to a higher priority on the public agenda.
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