IOM Study on Mental Health Workforce of Older Adults Fact Sheet

2008 IOM Report

In April 2008, the Institute of Medicine released a report entitled Retooling For An Aging America:  Building The Health Care Workforce, a broad study on the geriatric health care workforce.  While that study was very helpful and did an excellent job in addressing all aspects of the workforce crisis, its broad scope precluded the in-depth consideration of the workforce needed to address mental and behavioral health.

 Specifically, AAGP felt that there remained a need to examine the access and workforce barriers unique to geriatric mental health care services and to articulate the importance of integrating geriatric mental health services into all models of geriatric service delivery.  Retooling the health care system for the mental health care needs of older adults involves overcoming structural, social, recruitment/retention, and reimbursement barriers that are unique to mental health service delivery, and require specific solutions.

Often, biological, psychological and social factors conspire to diminish the quality of life for older adults, especially those with mental health conditions such as Alzheimer’s disease and other dementias, depression, anxiety and substance abuse.  AAGP strongly believed that a targeted report on these issues could greatly influence future policy and resource allocation decisions that will need to be made as the baby boom generation ages. 

Concerned about the diminishing numbers of mental health care works trained in geriatrics, AAGP began to advocate strongly for an aging and mental health study to complement the IOM’s 2008 broad study of the geriatric workforce.

Fiscal Year 2010 Labor-HHS Appropriations:  Funding An IOM Study

The Labor-Health and Human Services Appropriations bill for Fiscal Year 2010 contained a provision providing $900,000 in funding for an IOM study on the mental health workforce for aging and ethnic populations.  AAGP had initiated the request for this study in 2008 and was joined in this effort by the American Psychiatric Association, the American Psychological Association, and the National Association of Social Workers.  It was supported throughout the FY 2010 appropriations process by Representatives Rosa DeLauro (D-Connecticut), Patrick Kennedy (D-Rhode Island), Senator Herb Kohl (D-Wisconsin) and others.

2011- 2012 – Current IOM Study:  The Mental Health Workforce Needs of Older Adults

In February 2011, the IOM announced the formation of a new consensus study, the Mental Health Workforce for Geriatric Populations, to examine the mental health care workforce needed for a growing older population.

The IOM will seek to determine the mental and behavioral health care needs of Americans who are over 65 years of age and make policy recommendations for meeting those needs through a competent and well-trained mental health workforce, especially in light of the projected doubling of the older adult population by 2030.

According to the IOM, it will:

  •  Provide a systematic and trend analysis of the current and projected mental and behavioral health care needs of Americans 65 years and older;
  • Within the older population, consider the special needs of growing ethnic populations, of veterans with post-traumatic stress disorder, and of persons with chronic disease; and
  • Weigh the impact of improved diagnostic techniques, of addressing mental health issues as part of effective chronic disease management, and the implementation of the Federal mental health parity law on meeting the mental health needs of older adults.

IOM recommendations will take into consideration forces that shape the health care workforce, such as education, training, modes of practice, and the financing of public and private programs.  The IOM study committee met throughout 2011, and it is anticipated that the report will be released in the spring/summer of 2012.

Shortage of Geriatric Mental Health Specialists – A National Crisis

The proportion of the population over age 65 will increase from 12.4% of the U.S. population in 2000 to 20% by the year 2030 (U.S. Census Bureau, 2000). During the same time period, the number of older adults with mental illness is expected to double to 15 million (Jeste et. al., 1999).

This demographic transition will increase the current shortfall of health care providers with geriatric expertise – and specifically health care providers with geriatric mental health expertise. Since 1990, approximately 2,500 psychiatrists have received subspecialty certification in geriatric psychiatry. This supply of physicians is woefully inadequate to meet the future needs of the nation. According to estimates in the President’s Commission on Mental Health Subcommittee on Older Adults (2003), “at the current rate of graduating approximately 80 new geriatric psychiatrists each year and an estimated 3% attrition, there will be approximately 2,640 geriatric psychiatrists by the year 2030 or one per 5,682 older adults with a psychiatric disorder.” It has been estimated that 4,000 – 5,000 geriatric psychiatrists who provide patient care are needed (National Institute on Aging, 1997) and an additional 1,220 physician faculty members and 919 non-physician faculty members who provide training in geriatric psychiatry to meet the future demand.

(March 2012)