Expanding the Pipeline
There are vastly inadequate numbers of specialists in geriatric mental health care, including geriatric psychiatry, and when this is combined with the dramatic growth of the population of over age 65, estimated to rise to 20 percent of the U.S. population in 2030 , it foretells a crisis in health care that has already begun to impact older adults and their families nationwide. Unless substantial changes are made immediately, older Americans will face long waits, decreased choice, and suboptimal care. Consequently, AAGP urges Congress, the regulatory agencies, and leaders in health care policy to act upon the IOM’s report to make the necessary changes to recruit and retain a skilled workforce in geriatrics and geriatric mental health care and to adopt an efficient and effective organization of geriatric medical and mental health care services.
In April 2008, the Institute of Medicine issued a report entitled, Retooling for an Aging America: Building the Health Care Workforce, which concludes that, without changes at the national level, older Americans will lack access to affordable, quality health care – including mental health care. AAGP has long been concerned about the workforce in the area of late-life mental health care, particularly the declining numbers of doctors entering the field of geriatric psychiatry – those pursuing a research career, becoming clinician-educators, or entering clinical practice. The diminishing workforce in these areas will inevitably lead to inadequate access to quality mental health care for the aging Baby Boomers generation. There is a need for a critical mass of specialty-trained subspecialists to carry out research, to teach and train others in graduate medical education and institutional and community based continuing education efforts, and to serve as clinical resources for consultation, community education, and tertiary care in communities. These needs require a robust pipeline of geriatric psychiatry fellows who will pursue a variety of career paths in geriatric psychiatry and systematic efforts to assure that they are willing and able to continue their work in the field.
The Institute of Medicine is currently undertaking a follow-up study of the current and projected mental and behavioral healthcare needs of the American people, particularly for aging and growing ethnic populations. This study, authorized by Congress in 2009, will complement the 2008 IOM study by providing in-depth consideration of the mental health needs of geriatric and ethnic minority populations that were precluded by the broad scope of the earlier one.