Statements on Introduced Bills and Joint Resolutions
Floor Speech
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By Ms. COLLINS (for herself and Ms. MIKULSKI):
S. 525. A bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; to the Committee on Health, Education, Labor, and Pensions.
Ms. COLLINS. Mr. President, I am pleased to join my colleague from Maryland, Senator Mikulski, in introducing the Positive Aging Act, which will help to increase older Americans' access to quality mental health screening and treatment services in community-based care settings.
The legislation we are introducing today is particularly important for States like Maine that have a disproportionate number of older persons. Fifteen percent of Maine's population is 65 or older, and, with the highest median age, Maine is the ``oldest'' State in the nation. Moreover, our percentage of older adults is increasing, and, by 2030, more than one in five Mainers will be over the age of 65.
One of the most daunting public health challenges facing our Nation today is how to increase access to quality mental health services for the more than 44 million Americans with severe, disabling mental disorders that can devastate their lives and the lives of the people around them.
What is often overlooked, however, is the prevalence of mental illness among our Nation's elderly. Studies have shown that more than one in five Americans aged 65 and older experience mental illness, and that as many as 80 percent of elderly persons in nursing homes suffer from some kind of mental impairment. Particularly disturbing is the fact that the mental health needs of older Americans are often overlooked or not recognized because of the mistaken belief that they are a normal part of aging and therefore cannot be treated.
While older Americans experience the full range of mental disorders, the most prevalent mental illness afflicting older people is depression. Ironically, while recent advances have made depression an eminently treatable disorder, only a minority of elderly depressed persons are receiving adequate treatment. Unfortunately, the vast majority of depressed elderly don't seek help. Many simply accept their feelings of profound sadness and do not realize that they are clinically depressed.
Moreover, those who do seek help are often underdiagnosed or misdiagnosed, leading the National Institute of Mental Health to estimate that 60 percent of older Americans with depression are not receiving the mental health care that they need. Failure to treat this kind of disorder leads to poorer health outcomes for other medical conditions, higher rates of institutionalization, and increased health care costs.
Fortunately, important research is being done that is developing innovative approaches to improve the delivery of mental health care for older adults by integrating it into primary care settings. This research demonstrates that older adults are more likely to receive appropriate mental health care if there is a mental health professional on the primary care team, rather than simply referring them to a mental health specialist outside the primary care setting. Multiple appointments with multiple providers in multiple settings simply don't work for older patients who must also cope with concurrent chronic illnesses, mobility problems, and limited transportation options. The research also shows that there is less stigma associated with psychiatric services when they are integrated into general medical care.
The Positive Aging Act builds upon this research and authorizes funding for projects that integrate mental health screening and treatment services into community sites and primary care settings. Specifically, the Positive Aging Act of 2011 would authorize the Substance Abuse and Mental Health Services Administration to fund demonstration projects to support integration of mental health services in primary care settings. It would also support grants for community-based mental health treatment outreach teams to improve older Americans' access to mental health services. To ensure that these geriatric mental health programs have proper attention and oversight, it would mandate the designation of a Deputy Director for Older Adult Mental Health Services in the Center for Mental Health Services, and it would also include representatives of older Americans or their families and geriatric mental health professionals on the Advisory Council for the Center for Mental Health Services. Finally, it would require state plans under Community Mental Health Services Block Grants to include descriptions of the states' outreach to and services for older individuals.
We are fortunate today to have a variety of effective treatments to address the mental health needs of American seniors. The Positive Aging Act will help to ensure that older Americans have access to these important services. I therefore urge my colleagues to sign on as cosponsors of the legislation, which has been endorsed by a broad coalition of mental health and senior organizations, including the Alzheimer's Association, the American Geriatrics Society, the American Psychiatric Association, the American Psychological Association, the American Association for Geriatric Psychiatry, and the National Council on Aging.
Mr. President, I ask uanimous consent that a letter of support be printed in the Record.
There being no objection, the material was ordered to be printed in the RECORD, as follows:
March 7, 2011.
Hon. Susan M. Collins,
U.S. Senate, Dirksen Senate Office Building, Washington, DC.
Hon. Barbara A. Mikulski,
U.S. Senate, Hart Senate Office Building, Washington, DC.
DEAR SENATORS COLLINS AND MIKULSKI: On behalf of the undersigned organizations, we are writing to applaud your ongoing commitment to the mental and behavioral health needs of older Americans and express our strong support for the Positive Aging Act, which you are planning to introduce in the near future. This important legislation will improve access to vital mental and behavioral health care for older adults by supporting the integration of mental health services in primary care and community settings.
An estimated 20 percent of community-based older adults in the U.S. have a mental health problem. These disorders can have a significant impact on both physical and mental health, often leading to increases in disease, disability, and mortality. In fact, men age 85 and older currently have the highest rates of suicide in our country and depression is the foremost risk factor. Evidence suggests that up to 75 percent of older adults who die by suicide have visited a primary
care professional within 30 days of their death. Although effective treatments exist, the mental health needs of many older Americans go unrecognized and untreated because of poorly integrated systems of care to address the physical and mental health needs of seniors.
The Positive Aging Act takes an important step toward improving access to quality mental and behavioral health care for older adults by integrating mental health services in primary care and community settings where older adults reside and receive services. By supporting collaboration between interdisciplinary teams of mental health professionals and other providers of health and social services, this legislation promotes an integrated approach to addressing the health and well being of our nation's growing older adult population.
We commend you for your leadership and commitment to the mental and behavioral health needs of older adults and look forward to working with you to ensure passage of the Positive Aging Act.
Sincerely,
Alzheimer's Association; Alzheimer's Foundation of America; American Assisted Living Nurses Association; American Association for Geriatric Psychiatry; American Association for Long Term Care Nursing; American Association for Psychoanalysis in Clinical Social Work; American Association for Psychosocial Rehabilitation; American Association on Health and Disability; American Foundation for Suicide Prevention/SPAN USA; American Geriatrics Society; American Group Psychotherapy Association; American Mental Health Counselors Association; American Nurses Association; American Occupational Therapy Association; American Orthopsychiatric Association; American Psychiatric Association; American Psychological Association; American Psychotherapy Association; American Society on Aging; Anxiety Disorders Association of America.
Association for Ambulatory Behavioral Healthcare; Bazelon Center for Mental Health Law; Clinical Social Work Association; Clinical Social Work Guild 49; Council of Professional Geropsychology Training Programs; Depression and Bipolar Support Alliance; Direct Care Alliance; Geriatric Mental Health Alliance of New York; Gerontological Society of America; Illinois Coalition on Mental Health and Aging; Iowa Coalition on Mental Health and Aging; Jewish Federation of Metropolitan Chicago; Jewish Federations of North America; Kansas Advocates for Better Care; Kansas Suicide Prevention Committee; Mental Health America; Midland Area Agency on Aging; National Alliance for Caregiving; National Association for Behavioral Health; National Association for Children's Behavioral Health.
National Association of Area Agencies on Aging; National Association of Social Workers; National Association of State Mental Health Program Directors; National Center for Assisted Living; National Coalition on Care Coordination; National Consumer Voice for Quality Long-Term Care; National Council for Community Behavioral Health care; National Council on Aging; National Council on Problem Gambling; National Foundation for Mental Health; New Hampshire Coalition on Substance Abuse, Mental Health & Aging; Oklahoma Mental Health and Aging Coalition; PHI--Quality Care through Quality Jobs; Psychologists in Long Term Care; US Psychiatric Rehabilitation Association; Witness Justice.
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