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Mental Health/Substance Abuse Home Page

Excerpt from the California State Plan on Aging, 2009-2013 (pages 25-26)

Mental Health

Mental health is inseparable from physical health and wellness. The Surgeon General in its Mental Health Report estimated that 20 percent of people over age 55 experience mental health problems that are not a part of "normal aging." An estimated 11 percent suffer from anxiety, 6.4 percent have cognitive impairments, 4.4 percent experience depression and other mood disorders, and 0.6 percent are diagnosed with schizophrenia. 23 The AoA estimates that only half of all older adults who acknowledge mental health problems are treated. 24 This is particularly true for older adults who are racially, ethnically and culturally diverse.

Untreated mental illness in older adults can cause significant disability and increase the risk of hospitalization, institutionalization, and mortality. It also can contribute to self-neglect and abuse. Untreated depression is the strongest risk factor for suicide. Older adults age 65 and older have the highest suicide rate of all age groups. Older White men are at six times greater risk for suicide than the general population. The National Institute of Mental Health indicates that older adults who commit suicide have visited their primary care physician close to the time of the suicide: 20 percent on the same day; 40 percent within one week; and 70 percent within one month of the suicide. 25 These findings underscore the urgent need to improve the identification and treatment of depression and suicide risk among older adults. Family caregivers of persons with dementia also are at high risk for depression and its serious consequences. 26

In 2004, California passed Proposition 63, the Mental Health Services Act (MHSA). The MHSA established an ongoing funding source to promote mental health service development that is guided by evidence-based and promising practices. The law mandates a State and local stakeholder process through which to develop and implement MHSA policies. The Department is participating in the State-level MHSA stakeholder process and engages aging service providers to participate at the county level to promote older adult mental health service development. These activities are consistent with the 2006 Amendments to the OAA which seek to promote public awareness about mental health issues in older adults and improve diagnosis and treatment in coordination with mental health service providers.

Substance Abuse

Abuse and misuse of alcohol, prescription, and other drugs, affects an estimated 20 percent of older adults. This percentage is expected to rise as the Baby Boomers age. Physiological changes in older adults can make alcohol and medications harmful at doses lower than those used by younger people; many older adults are unaware of this fact. Older adults receive 25 to 30 percent of all prescriptions and experience more than half of all reported adverse drug reactions that lead to hospitalization.26 Thirty percent of persons over age 65 take eight or more prescription drugs daily. 27

Substance abuse is destructive. It can negatively impact health, mental health, family and social relationships, and quality of life. It may be difficult to identify and address due to the reluctance or lack of awareness of the older adult, the caregiver or the service provider. As with mental illness, it is important that substance abuse and misuse be identified and treated by service providers with special competencies, using an integrated approach that involves both the mental health and substance abuse treatment systems. When substance abuse co-occurs with mental disorders, it increases the risk of poor health outcomes, inpatient and outpatient service use, and suicidal thoughts and attempts. 28

23 U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General-Older Adults and Mental Health. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.

24 U.S. Department of Health and Human Services. Older Adults and Mental Health: Issues and Opportunities. Washington, DC: U.S. Department of Health and Human Services, Administration on Aging, January 2001.

25 U.S. Department of Health and Human Services. Depression and Suicide Facts for Older Adults. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health, 2004.

26 SAMHSA - Get Connected: Linking Older Americans with Medication, Alcohol, and Mental Health Resources. DHHS Pub. No. (SMA) 03-3824, Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2003.

27 Center for Substance Abuse Treatment. Substance Abuse Among Older Adults. Treatment Improvement Protocol (TIP) Series, Number 26. DHHS Publication No. (SMA) 07-3918. Rockville, MD: Substance Abuse and Mental Health Services Administration, 1998.

28 U.S. Department of Health and Human Services. Co-occurring Substance Abuse and Mental Health Issues in Older Adults. Rockville, MD: Older Americans Substance Abuse and Mental Health Technical Assistance Center, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from the SAMHSA web site: http://www.mentalhealth.samhsa.gov


Related links


Mental Health Services Act (MHSA):

CDA MHSA Activities: (Coming Soon)

  • MHSA Work Plans and Progress Reports
  • MHSA Reports and Stakeholder Comments
  • MHSA Presentations

Mental Health and Substance Abuse Information on Older Adults:

Evidence-Based/Promising Practices:

Mental Health and Substance Abuse Education/Training Resources: