Mental Health
Barriers to accessing mental health assistance
For a more detailed discussion of transportation barriers, visit the Transportation section of Aging Texas Well. In some areas, community mental health centers actively collaborate with the area agency on aging to provide services. This partnership offers consumers greater access to services such as education, case management, support, and respite for family caregivers. In these communities, there was also a marked increase in the number of mental health services available to older people. Even when communities have the capacity to respond to the mental health needs of older adults, they are often challenged by a lack of knowledgeable staff to provide mental care. Staff can also tend to be deficient in delivering appropriate and culturally sensitive prevention and treatment services to minorities.
Limited utilization is further exacerbated by financial barriers within standard health insurance policies and federally-funded programs. For example, Medicare does not adequately cover mental health screening, diagnosis, community services, and medication. Medicare reimbursement is limited to 190 days (lifetime) in inpatient psychiatric care, a 50 percent co-payment for outpatient psychotherapy services, and partial payments for acute psychiatric distress. Furthermore, Medicare does not pay for outpatient prescription medications. Similarly, many managed care programs lack the specialized support services needed by older people with severe chronic mental illness. The Centers for Medicare and Medicaid Services (CMS) has not yet established a national coverage policy for assessing the appropriateness of claims for mental health services. Instead, carriers are allowed to develop their own policies and criteria for determining medical necessity. It is now clear that this optional approach will not ensure mental health services for people in need.
Updated: November 2, 2007
