[Congressional Record Volume 156, Number 117 (Wednesday, August 4, 2010)]
[Senate]
[Page S6738]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
By Ms. COLLINS (for herself and Ms. Mikulski):
S. 3698. A bill to amend the Public Health Services Act to provide
for integration of mental health services and mental health treatment
outreach teams, and for other purposes; to the Committee on Health,
Education, Labor, and Pensions.
Ms. COLLINS. Mr. President, I am pleased to join my colleague from
Maryland, Senator Mikulski, in introducing the Positive Aging Act,
which will help to increase older Americans' access to quality mental
health screening and treatment services in community-based care
settings.
The legislation we are introducing today is particularly important
for states like Maine that have a disproportionate number of older
persons. Fifteen percent of Maine's population is 65 or older, and,
with the highest median age, Maine is the ``oldest'' State in the
nation. Moreover, our percentage of older adults is increasing, and, by
2036 more than 1 in 5 Mainers will be over the age of 65.
One of the most daunting public health challenges facing our nation
today is how to increase access to quality mental health services for
the more than 44 million Americans with severe, disabling mental
disorders that can devastate their lives and the lives of the people
around them.
What is often overlooked, however, is the prevalence of mental
illness among our Nation's elderly. Studies have shown that more than 1
in 5 Americans aged 65 and older experience mental illness, and that as
many as 80 percent of elderly persons in nursing homes suffer from some
kind of mental impairment. Particularly disturbing is the fact that the
mental health needs of older Americans are often overlooked or not
recognized because of the mistaken belief that they are a normal part
of aging and therefore cannot be treated.
While older Americans experience the full range of mental disorders,
the most prevalent mental illness afflicting older people is
depression. Ironically, while recent advances have made depression an
eminently treatable disorder, only a minority of elderly depressed
persons are receiving adequate treatment. Unfortunately, the vast
majority of depressed elderly don't seek help. Many simply accept their
feelings of profound sadness and do not realize that they are
clinically depressed.
Moreover those who do seek help are often underdiagnosed or
misdiagnosed, leading the National Institute of Mental Health to
estimate that 60 percent of older Americans with depression are not
receiving the mental health care that they need. Failure to treat this
kind of disorder leads to poorer health outcomes for other medical
conditions, higher rates of institutionalization, and increased health
care costs.
Fortunately, important research is being done that is developing
innovative approaches to improve the delivery of mental health care for
older adults by integrating it into primary care settings. This
research demonstrates that older adults are more likely to receive
appropriate mental health care if there is a mental health professional
on the primary care team, rather than simply referring them to a mental
health specialist outside the primary care setting. Multiple
appointments with multiple providers in multiple settings simply don't
work for older patients who must also cope with concurrent chronic
illnesses, mobility problems, and limited transportation options. The
research also shows that there is less stigma associated with
psychiatric services when they are integrated into general medical
care.
The Positive Aging Act builds upon this research and authorizes
funding for projects that integrate mental health screening and
treatment services into community sites and primary care settings.
Specifically, the Positive Aging Act of 2010 would authorize the
Substance Abuse and Mental Health Services Administration to fund
demonstration projects to support integration of mental health services
in primary care settings. It would also support grants for community-
based mental health treatment outreach teams to improve older
Americans' access to mental health services. To ensure that these
geriatric mental health programs have proper attention and oversight,
it would mandate the designation of a Deputy Director for Older Adult
Mental Health Services in the Center for Mental Health Services, and it
would also include representatives of older Americans or their families
and geriatric mental health professionals on the Advisory Council for
the Center for Mental Health Services. Finally, it would require state
plans under Community Mental Health Services Block Grants to include
descriptions of the states' outreach to and services for older
individuals.
We are fortunate today to have a variety of effective treatments to
address the mental health needs of American seniors. The Positive Aging
Act will help to ensure that older Americans have access to these
important services. I therefore urge my colleagues to sign on as
cosponsors of the legislation, which has been endorsed by a number of
mental health and senior organizations, including the Alzheimer's
Association, the American Geriatrics Society, the American Psychiatric
Association, the American Psychological Association, the American
Association for Geriatric Psychiatry, and the National Alliance on
Mental Illness.
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