Psychology is the study of the mind and behavior. Psychology is unique in that it is both a

service-oriented health care profession and a field of scientific research. Hence, the roles of the

psychologist are many—researcher, educator, licensed health care provider, and policy advocate.

Psychologists are highly trained professionals—their education involves a median of 7 years of

education and training beyond an undergraduate degree.

What Is Geropsychology?

Geropsychology is a field within psychology devoted to the study of aging and the provision

of clinical services for older adults. As researchers, geropsychologists expand knowledge of

the normal aging process and design and test psychological interventions that address problems

that commonly arise as people age. As health care practitioners, psychologists help older

persons and their families overcome problems, enhance well-being, and achieve maximum

potential during later life.

The Growing Need for Psychological Services for Older Adults

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The demand for mental health practitioners with expertise in older adult care will expand as

the older population grows. Demand for mental health services is expected to rise as large

cohorts of middle-aged individuals—who are more accepting of mental health services than

the current generation of older people—move into old age.

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Researchers estimate that almost two-thirds of older adults with a mental disorder do not

receive needed services. This problem is particularly acute in rural and underserved groups,

such as those living in poverty and some ethnic and racial groups.

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Research suggests that a majority of older adults would want to be treated should they

become depressed. When given a choice for the treatment of depression, older adults often

prefer psychological services to antidepressant medication. Older adults report feeling

comfortable receiving mental health services from qualified mental health professionals.

The Interface Between Physical and Mental Health Care

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Studies indicate that 50-70% of all primary care medical visits are related to psychological

factors such as anxiety, depression, and stress. In rural and underserved areas, it may be that

primary care medical services are the only health care available.

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Physical and mental health affect each other. For example, older adults with medical problems

such as heart disease have higher rates of depression than those who are medically well.

Conversely, untreated depression in an older person with heart disease negatively affects the

outcome of the disease. Even mild depression lowers immunity and may compromise a

person’s ability to fight infections and cancers.

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Depression has a powerful negative impact on ability to function, resulting in high rates of

disability. The World Health Organization projects that by the year 2020, depression will

remain a leading cause of disability, second only to cardiovascular disease.

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Recognition and treatment of mental health conditions in the medically ill may be especially

difficult. As most older adults have one or more chronic medical conditions, psychologists’

skills are particularly useful in diagnosis and treatment.

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Integration and coordination of care by geropsychologists with primary care professionals

have been shown to decrease the frequency of older adults’ primary care visits and use

of medication.

Policy Recommendations To Improve Mental Health Care for

Older Americans

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Enhance opportunities for professional training in the psychology of aging at the doctoral and

postdoctoral levels of education to address the growing number of older adults in need of

mental and behavioral health services.

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Expand basic and applied behavioral research at the National Institute of Mental Health and

the National Institute on Aging. Increase funding for research training in geropsychology and

for the widespread dissemination of evidence-based psychological treatment for mental health

problems of older adults.

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Increase the early identification and treatment of older adults with mental health problems

through outreach and the provision of services offered in places older adults frequent,

such as primary care settings, congregate meal and senior centers, residential settings,

libraries, and other community sites.

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Support legislation to increase the availability of and access to effective mental health

services for older adults. Barriers to treatment include financial costs; lack of parity

between reimbursement of health vs. mental health services; poor recognition and diagnosis

of mental health conditions among older adults; lack of programs focusing on older adult

mental health issues; reluctance of primary care providers to refer to mental health

professionals; transportation; living in a rural or underserved area; and stigma.

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Increase funding through Medicaid, the Older Americans Act, and the Community Mental

Health Services Block Grant to expand the availability of mental health and related supportive

services to older adults.

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Increase coordination of mental and physical health care. Because of the often-complex

interplay of physical and mental health problems in older adults, interdisciplinary care is

needed to provide optimal care.