Government Relations Update

Today's mental health workforce is seriously inadequate in size to meet the mental health and substance use needs among older adults, and most providers who work with people 65 and older have not had specialized training to assess or treat this population, said APA member Michael A. Hoge, PhD, to a crowd of congressional staff, federal agency leaders and others at a Sept. 19 Capitol Hill briefing. Yet "despite the dire need, there is a conspicuous lack of attention to preparing a workforce to care for older Americans," said Hoge.

APA co-hosted the briefing to highlight key policy recommendations from the new Institute of Medicine (IOM) report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? Hoge was a member of a panel of speakers that also included Dan G. Blazer, PhD, MD, IOM Committee Chair from Duke University Medical Center, and María P. Aranda, PhD, MSW, IOM Committee Member from the University of Southern California.

Speaking on behalf of APA, Hoge shared the following recommendations to expand the psychology workforce in response to the unmet need:

  • Increase federal funding for education and training opportunities in geriatrics for psychologists and trainees.
  • Ensure the inclusion of psychologists as members of integrated health-care teams.
  • Increase older adults' access to mental health care by enacting Medicare and Medicaid policies that appropriately reimburse psychologists for the provision of mental and behavioral health services.

According to APA Chief Executive Officer Norman B. Anderson, PhD, the IOM report provides a foundation for the nation to build a psychology and mental health workforce to meet the needs of the rapidly growing and increasingly diverse aging population. "The report includes key policy recommendations, which APA looks forward to promoting in partnership with federal, professional and community leaders," Anderson says.

IOM appointed three APA members to serve on its study committee: Hoge, of the Yale University School of Medicine; Margarita Alegría, PhD, of the Center for Multicultural Mental Health Research and Harvard Medical School and Frederic C. Blow, PhD, of the University of Michigan Medical School and the Department of Veterans Affairs.

This study is a follow-up to the 2008 IOM report, Retooling for an Aging America: Building the Health Care Workforce, which projected health-care needs for the growing and increasingly diverse aging population. Funding for the new study was secured following a nearly two-year advocacy campaign led by APA and partners from the American Association for Geriatric Psychiatry, the National Association of Social Workers and the American Psychiatric Association. Rep. Rosa DeLauro (D-Conn.), former Rep. Patrick Kennedy (D-R.I.), and Sen. Herb Kohl (D-Wis.) designated $900,000 to fund the study.

In addition to playing a critical role in securing the funding for the study, APA supported the work of the study committee by providing workforce data and information on psychology's role in addressing the mental and behavioral health needs of older adults and the evolution of professional geropsychology. "The IOM report was clearly informed by resources shared by APA, and we are pleased to see psychologists appropriately recognized as key providers of evidence-based services for older adults and their families," said Deborah DiGilio, MPH, who directs APA's Office on Aging.

APA continues to facilitate the dissemination and implementation of the IOM policy recommendations and supports the essential role of psychologists in meeting the urgent mental health and substance use needs of America's diverse aging population.

Nida Corry, PhD, is a senior legislative and federal affairs officer in APA's Public Interest Government Relations Office and is co-director of APA's Congressional Fellowship Program.

Dr. Michael Hoge

Michael A. Hoge, PhD, presented the IOM report findings at a well-attended 2012 APA Annual Convention symposium, "The Geriatric Mental Health Workforce: Current Initiatives and Critical Issues." Co-panelists included Daniel Segal, PhD, University of Colorado at Colorado Springs; Erin Emery, PhD, Rush University Medical Center; and Michele Karel, PhD, of the VA Central Office and Harvard Medical School. Cynthia Belar, PhD, executive director of the APA Education Directorate, chaired the session and Antonette Zeiss, PhD, chief consultant for mental health at the Department of Veterans Affairs, served as the discussant. The recording is available online and qualifies for two continuing-education credits.