A bill before Congress aims to improve the mental health of older Americans
through better coordination and training of primary care physicians to
diagnose mental illness and reduce record suicide rates among this
population.
The bill, the Positive Aging Act of 2009 (HR 3191), was introduced by Rep.
Patrick Kennedy (D-R.I.) in July to spur the use of improved psychiatric
screening and diagnostic tools by primary care physicians and improve the
training of those clinicians in identifying mental disorders in their
geriatric patients. The measure also would encourage increased collaboration
with mental health professionals on site in primary care settings that serve
low-income seniors.
"The disconnect between primary care and mental health care means
that older adults seen by their primary care physicians are too often
misdiagnosed or improperly treated, and they continue to suffer from
depression and other mental illnesses that complicate their medical conditions
and lead to excess physical disability," said Charles Reynolds III,
M.D., president of the American Association for Geriatric Psychiatry (AAGP),
in a written statement.
The legislation, which is supported by APA and allied mental health groups,
targets that disconnect by authorizing funding for Medicare pilot programs
that offer mental health screenings, referrals for follow-up care and
consultations, and the provision of the leading "evidence-based
protocols" for treating common mental health disorders. Grants would
fund community-based mental health treatment outreach teams to provide
services in primary health care facilities where many older Americans receive
medical treatment.
Kennedy said that mental health screenings and preventive care are critical
to seniors' overall health. The need for the legislation is highlighted by
studies suggesting that 20 percent of elderly Americans experience a mental
disorder at any given time, but more than 50 percent of those cases go
untreated.
"An even bigger problem is that there are effective treatments for
the disorders, but our system does a poor job of integrating these much-needed
services," said Rep. Ileana Ros-Lehtinen (R-Fla.), a cosponsor of the
bill.
Other data that demonstrate the need for increased mental health care for
this population include findings that men aged 85 and older have the highest
rate of suicide in the nation, and untreated depression is the leading risk
factor in such deaths, Reynolds said.
"It's tragic that one-third of older adults who commit suicide have
seen their primary care physician in the week before completing suicide, and
70 percent have seen their doctors within the prior month," Reynolds
said.
These are among other provisions of the legislation:
The AAGP has called on its members and other mental health advocates to
contact their legislators and urge them to include the provisions of the bill
in health care reform legislation.
The legislation was originally introduced in 2002 after Kennedy consulted
with the AAGP and other mental health advocates on changes needed to improve
the care that seniors receive for psychiatric illness.
The text of the Positive Aging Act of 2009 can be accessed at<http://thomas.loc.gov>
by searching on the bill number, HR 3191. ▪