Abipartisan group of legislators introduced the Positive Aging Act of 2004
last month in the House and Senate to improve older Americans' access to
quality mental health
Sen. Hillary Rodham Clinton (D-N.Y.) addresses the media at a Capitol
Hill briefing last month on the Positive Aging Act. With her are (from left)
Sen. Susan Collins (R-Maine) and Reps. Ileana Ros-Lehtinen (R-Fla.) and
Patrick Kennedy (D-R.I.).
APA, the American Association for Geriatric Psychiatry (AAGP), National
Council on Aging, and National Mental Health Association endorsed the
legislative proposal to reform the delivery of mental health care to the
"The current system's failure to diagnose and treat mental illnesses
takes a tremendous toll on seniors and their families," APA stated in a
The most common psychiatric disorders among the elderly are anxiety,
depression, and dementia. Americans aged 65 and older have the highest suicide
rate in the United States, the bill points out.
A striking statistic is that 20 percent of older Americans committed
suicide the same day they saw their primary care physician, Rep. Patrick
Kennedy (D-R.I.) said last month at a Capitol Hill briefing. He was joined by
Rep. Ileana Ros-Lehtinen (R-Fla.) and Sens. Hillary Rodham Clinton (D-N.Y.),
and Susan Collins (R-Maine).
The bill would fund projects that integrate mental health services,
especially early screening and appropriate referrals for follow-up care with
primary care services in community settings.
"We want to make treatment available where seniors already
are—whether that means primary care sites, community health centers, or
private practices," said Clinton.
"The mental health needs of the elderly are often overlooked or not
recognized because of the mistaken belief that mental illness is a normal part
of the aging process," said Collins.
Collins and Clinton are on the Senate Health, Education, Labor, and
Pensions Committee, which will vote on the bill before it can move on to the
full Senate. With only a few days left on the congressional calendar, any
action will most likely occur after Congress returns from its August
The legislation also calls for establishing community mental health teams
to visit the elderly where they either live or receive social services. The
latter includes senior centers, adult day care programs, assisted living
facilities, and community health centers.
Kennedy commented, "If you make it more convenient for seniors to
have access to mental health services, it has two effects. First, integration
with community primary care and social services reduces the stigma the elderly
associate with seeking mental health care. Second, the elderly are more likely
to access treatment when it's convenient and easy to find."
The bill would authorize the Substance Abuse and Mental Health Services
Administration (SAMHSA) to do the following:
The Positive Aging Act also calls for the creation of an Office of Older
Adult Mental Health Services in the Administration on Aging (AoA).
The AoA would provide grants to states to develop and test model mental
health systems that incorporate evidence-based protocols to detect and treat
mental illnesses in the elderly.
The legislation also authorizes the AoA to award grants for demonstration
projects providing mental health screening and treatment referrals for the
elderly living in rural areas, where few psychiatrists and mental health
The AoA would also award grants for projects that demonstrate
multidisciplinary collaboration in providing mental health screening and
treatment services to older Americans residing in urban areas.
APA applauded the legislation's multidisciplinary approach to treatment,"
which could involve psychiatrists working alongside other providers of
medical and social services."
The legislation would codify a SAMHSA/CMHS program that Congress has funded
in the amount of $5 million annually since Fiscal 2002 to provide
evidencebased mental health outreach and treatment to the elderly.
"President Bush's proposed Fiscal Year 2005 budget eliminated the
entire $5 million in funding for that program for the elderly," Kennedy
AAGP expressed outrage over the Bush administration's proposal to eliminate
funding for this program and over "the lack of attention by the
administration to the mental health needs of the fastest-growing segment of
the nation's population," according to a recent AAGP Action Alert.
Sen. John Breaux (D-La.), ranking minority member of the Senate Special
Committee on Aging, issued a statement at the press briefing in support of the
legislation. The Positive Aging Act builds on his bill of the same name that
failed to pass last year. Breaux agreed to have his bill incorporated into the
broader legislation introduced last month, according to his press release.
The Positive Aging Act of 2004 can be accessed online at<http://thomas.loc.gov>
by searching on the bill title. The legislation had not been assigned a Senate
or House number by press time. ▪