Summary: GAO discussed the status of mental health services for older clients. The study's findings are based on professional literature and visits to mental health agencies and nursing homes in two states. In addition, barriers to service development and their implications for an aging population were discussed.
GAO found that the emphasis Congress has placed on serving the elderly in mental health legislation has not been translated into effective service delivery by community mental health centers (CMHC). Although nursing homes do frequently provide health care for elderly patients with mental health problems, the treatment remains focused almost exclusively on physical illnesses. The CMHC program has been the principal federal response to the mental health needs of noninstitutionalized individuals. Block grant legislation transferred CMHC program administration to the states, but continued the requirements for providing specialized mental health services to the elderly. Local mental health providers have been hampered by limited knowledge regarding the mental health needs of older individuals. There has been a lack of coordination between mental health providers and social service agencies. The essential elements of a program for community mental health services for the elderly are: psychogeriatric assessment; outreach to identify and treat those in need; crisis management and emergency services; day treatment and day care; specialized outpatient treatment; case management; institutional care, sheltered living, and social support services; counseling to families of the elderly; and consultation and education. Mental health professionals agree that mental decline is not a normal aspect of aging and that many of the mental problems of the elderly are treatable, arrestable and, in some cases, curable.
