The Substance Abuse and Mental Health Service Administration – Center for Integrated Health Solutions presented a webinar, “Aging Well: Addressing Behavioral Health with Older Adults in Primary Care Settings” on 2-15-17. (to view the video, you must register. It is 90 minutes. I think that I have summarized the most important information.)
Here is what I learned:
- The rate of behavioral/mental health problems in the older adult population is increasing.
- Most of these problems are identified/diagnosed in PCP settings.
- This population has higher rates of some problems than younger populations:
- Suicidal risk, and attempts
- Cognitive impairments
- “polypharmacy challenges” – they are on a lot of medications
- Emergency Department visits
- It is common for these people to be resistant to referral to behavioral/mental health services, for a variety of reasons including:
- “I have lived through worse than this.”
- They do not want to have to tell their story repeatedly.
- Transportation barriers.
- PCP’s who are reluctant to refer – “I know this patient, so I can take care of the problem.”
- Factors that improve treatment outcomes for this population:
- Use of brief, structure therapies, typically provided in 4-8 sessions.
- High level of communication between the behavioral professional and the PCP team.
- When possible, behavioral services that are co-located, at least in the same building, helps with access and to reduce the stigma.
mhconcierge’s take: This is, obviously, a population that will be only increasing in numbers, and will provide opportunities for savvy mental health professionals to partner with PCPs to help meet the needs of older people. The wiliness and ability to coordinate closely with PCPs, such as with an E.H.R., is crucial.