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October 2015

Solving the Geriatric Mental Health Crisis in the 21st Century

Author Affiliations
  • 1Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Psychiatry. 2015;72(10):967-968. doi:10.1001/jamapsychiatry.2015.1306

There are too many of us and we are all too far apart.

Kurt Vonnegut, Welcome to the Monkey House, 19681

We are in the midst of an unprecedented demographic trend: we are aging. By 2050, the population aged 65 years and older in the United States will be 84 million. While there are many positive societal aspects to this trend (eg, violence and sociopathy will decrease), health care needs, including mental health, will increase. The 2012 Institute of Medicine report The Mental Health and Substance Abuse Workforce for Older Adults: In Whose Hands? highlights the unfolding crisis of our health care system lacking the capacity to help a growing elderly population in which 1 in 5 individuals has a mental disorder.2 An early taste of this crisis is the large and growing number of older adults who are given benzodiazepines for anxiety and insomnia.3 These sedative anxiolytics cause cognitive, motoric, and functional impairments in older adults; however, it is this very same demographic receiving a skyrocketing number of benzodiazepine prescriptions, particularly in rural America where mental health access is poorest. It is far better to treat the mental disorder than to give sedatives and settle for deleterious (and expensive) consequences, such as hip fracture, accelerated dementia, and functional decline. We need geriatric mental health treatments packaged in modern technology to extend their reach while retaining effectiveness.

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