[Congressional Record Volume 159, Number 80 (Friday, June 7, 2013)]
[Senate]
[Pages S4023-S4024]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Ms. Mikulski):
  S. 1119. 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 be joined by my colleague 
from Maryland, Senator Mikulski, in introducing the Positive Aging Act 
of 2013, which will help to increase older Americans' access to quality 
mental health screening and treatment services in community-based 
settings.
  The legislation we are introducing today is particularly important 
for States like Maine that have a disproportionate number of older 
persons. Sixteen 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; by 
2030, more than one in five 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 46 million American adults living with severe, disabling 
mental disorders that can devastate their lives and the lives of the 
people around them.
  What is often overlooked is the prevalence of mental illness among 
our Nation's elderly. Nearly one in five older adults in America have 
one or more mental health conditions. Moreover, older white males age 
85 and older have the highest rate of suicide of any group in the 
country. 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 effective treatments exist for mental health disorders, it is 
estimated that nearly two-thirds of older adults with a mental health 
problem do not receive the services they need. Older adults with 
evidence of a mental disorder are generally less likely than younger 
and middle-aged adults to receive mental health services and, when they 
do, they are less likely to receive care from a mental health 
specialist. Failure to treat mental disorders 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 2013 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 fund demonstration 
projects to support integration of mental health services in primary 
care settings. 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 numerous 
mental health, aging, and health care organizations, including the 
American Psychological Association, the American Association for 
Geriatric Psychiatry, the American Geriatrics Society, and the National 
Association of Social Workers.

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