By Kimberly A. Williams

The national shortage of practitioners with training and knowledge to meet the mental health and substance use needs of older adults has been known for quite some time. Experts have highlighted this impending crisis only to be met with a workforce woefully unprepared to adequately care for older Americans with mental illness and substance use problems. Unfortunately, very little has been done to confront this scarcity of expertise, perhaps because of a lack of political and societal will to provide proper care for older Americans.

However, with the recent release of the Institute of Medicine’s (IOM) much anticipated report on the drastic inadequacies of the mental health and substance abuse workforce for older adults, those of us who are concerned about older adult behavioral health now have the scientific evidence and consensus recommendations to tackle the issue head on. We must use the power of this report and its recommendations to advance geriatric behavioral health workforce policy and practice at all levels of government. In order to ensure appropriate attention to the report’s recommendations, we will need concerted, sophisticated advocacy at the national, state and local levels. Here are some of the key advocacy leadership groups that will be needed:

• A national advocacy group, such as the recently formed Aging and Mental Health Advocacy Network, to take the lead in initiating, coordinating and monitoring advocacy efforts around implementation of the report’s recommendations;
• National professional, trade, cause and consumer organizations concerned with elder mental health and substance use disorders and their state and local affiliates to be leading voices in supporting the realization of the recommendations;
• State, local and regional mental health and aging coalitions across the country to educate relevant state and local government leaders about the report, and press them to put in place appropriate report recommendations on a regional level, and for coalitions to share effective strategies.

As the report notes, the magnitude of the problem is so significant that no single approach or isolated modifications in federal agencies or programs can adequately address it. Overcoming the workforce challenge will require strong, coordinated action by all—government agencies; mental health, health, substance use, long-term care and aging service providers; associations; academics; researchers; advocates, and funders.

While making these necessary workforce changes will require financial investment and restructuring, which is difficult during a time of fiscal austerity, it will ultimately depend upon political will. All of us who care about older adults with behavioral health needs will need to persistently advocate together to be sure that our political leaders embrace and implement the IOM report recommendations. Change rarely happens quickly, so we must use the momentum of this report to aggressively press for change now. The future of accessible, quality mental health and substance use care for older adults depends on it.

Kimberly A. Williams, LMSW is the Director of the Geriatric Mental Health Alliance of New York and Director of the Center for Policy, Advocacy and Education at the Mental Health Association of New York City. Contact her at kwilliams@mhaofnyc.org.

This article was brought to you by the editorial committee of ASA’s Mental Health and Aging Network (MHAN).