Federally Funded Programs - Geriatric Mental Health Research And Services Fact Sheet

President Obama’s budget proposal for Fiscal Year (FY) 2012 is a first step towards his goal of keeping domestic discretionary spending essentially flat for the next five years, even though such spending accounts for only 12 percent of the total Federal budget.   

NIH

The President’s proposed FY 2012 budget provides $31.748 billion for the National Institutes of Health (NIH) for FY 2012, an increase of $745 million (2.4 percent) over the FY 2011 funding level.  The current (FY 2010) budget for the National Institute of Mental Health (NIMH) is $1.5 billion, which represented an increase of $39.2 million over FY 2009.  The Obama Administration has proposed an increase of $27 million for NIMH for FY 2012, for a total of $1.52 billion. For the National Institute on Aging (NIA),  the President has proposed an additional $20 million over current levels, which would bring the total appropriation to $1.13 billion.  . 

SAMHSA

The Substance Abuse and Mental Health Services Administration (SAMHSA) is now focused entirely on service delivery, with services research programs having been moved to NIMH.   Total funding for the Center for Mental Health Services in (CMHS) FY 2011 is $1.005 billion, and the Administration has proposed an increase of $22.5 million.  However, the proposal would eliminate the current program for evidence-based mental health outreach and treatment for the elderly, an initiative that was first proposed to Congress by AAGP and has been funded at or just under $5 million for each of the last eight fiscal years.  This is the only program at SAMHSA that focuses on older adults.  Also, the Administration proposes no funding for the newly authorized Academic Centers of Excellence for Depression.

HRSA

For FY 2012, the Administration has proposed funding of $48.7 million for geriatrics health professions education funding under Titles VII and VIII of the Public Health Service Act.  Among its provisions, the budget includes level funding for Geriatric Academic Career Awards (GACA) and Geriatric Education Centers (GECs), and increased funding (from $5.3 million to $8.5 million) for Geriatric Training for Physicians, Dentists, and Behavioral and Mental Health Professions.  It also includes $10 million for the new Geriatric Career Incentive Awards Program.

AAGP Position

AAGP supports increased Federal funding for research of mental disorders of the elderly. Mental illness is one of the most costly public health problems confronting the nation – impacting both government budgets and consumer spending. The personal and societal costs of mental illness are high. However, advances in research and treatment will help save lives, strengthen families and save taxpayer dollars.

As the population ages, scientific research and services must be funded at an accelerated rate to ensure that treatments and cures are found and available for some of the most devastating late-life mental illnesses such as Alzheimer’s disease and other dementias, anxiety, schizophrenia, substance abuse, sleep disorders, and depression.  AAGP is concerned that there is a continuing disparity between Federally funded research on mental health and aging and the projected mental health needs of older adults.  AAGP urges annual increases of funds targeted for geriatric mental health research at NIH to: (1) identify the causes of age-related brain and mental disorders to prevent mental disorders before they devastate lives; (2) speed the search for effective treatments and efficient methods of treatment delivery; and (3) improve the quality of life for older adults with mental disorders.

AAGP continues to advocate for Congressional action in recent years with respect to the relative decline in funding for senior mental health services through the Center for Mental Health Services (CMHS).  An important step forward in this effort was made in 2001. Following a recommendation made by AAGP in its testimony on mental health needs of older adults, the Labor-Health and Human Service (HHS) Appropriations bill for FY 2002 included $5 million to fund a new program within CMHS to provide evidence-based mental health outreach and treatment to the elderly.  Now, however, the Administration proposes to eliminate this program entirely, effectively ceding all responsibility for older adults to other agencies, such as the outreach efforts of the Administration on Aging (AoA) and funding for direct services by the Centers for Medicare and Medicaid Services (CMS).

AAGP believes that the current program must be continued and that efforts must be made to increase Federal funding for evidence-based outcomes research for the purposes of establishing best practices and medical standards for utilization in medical practices and quality patient care. This must be accomplished through a multi-pronged approach that includes NIMH and CMHS.

AAGP is also disappointed that the Administration has failed to propose funding for the new Academic Centers of Excellence for Depression, which was authorized in the health care reform law enacted in March 2010.  AAGP has pointed out the devastating toll of depressive and bipolar disorders on older adults and the lack of treatment that leads to poorer health outcomes and higher health costs for this population.  The work of these centers would be an essential component in the dissemination and implementation of evidence-based practices in clinical settings throughout the country.

The geriatric health professions program, which has been administered by the Health Resources and Services Administration (HRSA) under Title VII of the Public Health Service Act, has supported three important initiatives:  the Geriatric Faculty Fellowship has trained faculty in geriatric medicine, dentistry, and psychiatry; the Geriatric Academic Career Award program has encouraged newly trained geriatric specialists to move into academic medicine; and the Geriatric Education Center (GEC) program has provided grants to support collaborative arrangements that provide training in the diagnosis, treatment, and prevention of disease.  Authorization for these programs was augmented by new provisions in the health care reform legislation.  AAGP strongly urges increased funding for the newly expanded existing programs and full funding for the new initiatives under the bill.

(March 3, 2011)