Road less traveled - What Massachusetts can do to meet the mental health needs of seniors
By State Rep. William "Smitty" Pignatelli
“Hope is like a road in the country. There was never a road, but when many people walk on it, the road comes into existence. -Lin Yutang, Chinese writer and inventor
Massachusetts needs its head examined. Perhaps that would explain why, for far too long, the stigma of mental illness has hindered any attempts to meet the needs of the 200,000 residents in Massachusetts with severe mental illness. Seniors, in particular, represent a unique portion of this underserved population. Risk factors such as anxiety, depression, emotional loss, dementia, substance abuse and suicide speak loudly to a need for increased funding for mental health treatment; instead, funding and access to mental health services have been cut- in the case of some budget line-items-in half. This is completely unacceptable. As your state representative and a longtime advocate for access to mental health treatment, I am committed to working to ensure that the most recent funding cuts to these critical services are restored in the FY 2009 state spending plan. With enough legislative advocacy on its behalf, the journey to end the stigma of mental illness can truly begin with a single step.
Last spring, the Massachusetts Department of Mental Health (DMH) and the Executive Office of Elder Affairs (EOEA) conducted a series of forums and listening sessions across the state to identify ways to begin the work necessary to improving both the availability and quality of mental health treatment for older citizens. The individuals in each community who deliver mental health care on a daily basis submitted helpful input, but their suggestions, which are highlighted below, cannot be put into practice without adequate funding.
According to these caregivers at the front line of mental health treatment, many individuals, elders included, still believe there is something wrong with a person who needs mental health services. This stigma must be addressed before seniors can truly have their mental health needs met. I agree with the recommendations made by the DMH and EOEA that, in order to tackle the stigma of mental illness, funds can be used to train outreach workers to recognize the mental health needs of seniors as well as to develop outreach efforts to encourage seniors to use the behavioral services that are available to them.
For homebound elders, especially those in the Berkshires, transportation is critical. It is nearly impossible to obtain mental health and substance abuse interventions without it. Restored mental health funding can also help state agencies evaluate eligibility criteria that may hinder access to services as well as to address the unique needs of caregivers and elders in diverse ethnic populations.
Appropriate funding for the mental health needs of seniors also has the potential to address the level of effectiveness of the mental health treatment itself. Surely a 15-minute primary care visit cannot sufficiently yield a comprehensive assessment of one’s mental health needs and is, perhaps, something that could be alleviated by addressing the fact that Medicare and most insurers will not pay for mental health services in the same way they provide for “physical” illness. More work can be done to reduce caseloads and incentives should be made available for providers who serve seniors in their own homes.
All of the above suggestions are the result of state agency initiated community forums. I agree with each one of them, and I am confident that adequate funding for mental health services- a single step down what was once the road less traveled, will make all the difference.
Massachusetts State Representative Smitty Pignatelli represents the Fourth Berkshire District. He can be reached at 637-0631 or rep.smitty@hou.state.ma.us.
Editor’s Note: Depression among seniors is a growing problem. The highest suicide rate in the country is for males 85 and older.
