Barriers to Accessing Behavioral Health Services for Older Adults

Despite a high prevalence of mental health disorders and substance use disorders (SUDs) among older adults, many older adults encounter significant obstacles to accessing affordable care for these conditions. Issues contributing to challenges accessing behavioral health care include research gaps, stigma, ageism, workforce shortages, and health coverage limitations, among others. Read the full report.

Barriers specific to older adults:

• Gaps in behavioral health research specific to older adults. For example, tools used to screen for mental health disorders are not always proven to be effective in older adults, especially those with comorbid conditions. Evidence gaps also exist in effective treatments for certain behavioral health disorders among older adults.
• Ageism. Experiencing ageism or internalizing ageist beliefs can hinder older adults in seeking and receiving appropriate care and can worsen health outcomes.
• Shortages of professionals specialized in geriatrics and geriatric behavioral health. Shortages are in part tied to limited training in medical schools and other professional training programs as well as limited incentives for entering geriatric specialties.  
• Lack of parity in Medicare. Medicare is not subject to parity laws that prohibit health insurers from imposing more restrictive limits on mental health and SUD benefits than on medical and surgical benefits.

Broader systemic barriers:

• Stigma. Stigma surrounding mental illness and SUD persists and is associated with such access barriers as delayed care.
• Provider shortages. Mental health professional shortages affect psychologists, psychiatrists, and social workers, among others.
• Health insurance issues. Barriers relate to such issues as low reimbursement rates, strict prior authorization requirements, narrow provider networks, and inaccurate directories.
• Traditional division of behavioral health and primary care. Behavioral health care and primary care are often provided in separate, poorly coordinated systems.

This report underscores the urgent need for policy and programmatic efforts to address these barriers and ensure that older adults receive timely and affordable behavioral health care. This is critical to older adults’ quality of life and reducing the broader health and economic impacts of untreated mental health and substance use disorders.

Some text elements of this page were created with AI assistance and have been reviewed and edited for accuracy by staff.