The Importance of Integrated, Age-Friendly Care for Older Adults’ Mental Health

20% of older adults have a mental health diagnosis, yet they underutilize vital behavioral health services. That’s why integrated, age-friendly care is CRUCIAL! No more silos separating physical and mental healthcare. Read more in a recent Gerontological Society of America paper.

 

As we observe Mental Health Awareness Month and Older Americans Month, it’s crucial to shed light on the intricate relationship between aging and mental health. Approximately 20% of older adults have a mental health diagnosis, a statistic that demands our attention and action (Institute of Medicine, 2012). Behavioral health problems among this population are often intertwined with social barriers and social determinants of health, further compounding the challenges they face.

One of the significant barriers to optimal care is the compartmentalization of behavioral and physical health challenges. The coexistence of these issues can detrimentally affect medical outcomes (Shalev et al., 2021). Moreover, older adults in the United States tend to underutilize behavioral health services (Gunja et al., 2022), leaving their mental health needs unaddressed. Amidst the national social isolation and loneliness (SIL) epidemic, as highlighted by recent Surgeon General and National Academies reports (National Academies of Sciences, Engineering, and Medicine, 2020; US Surgeon General, 2023), mental health conditions and substance use disorders can both contribute to and result from social isolation among older adults. This vicious cycle necessitates a comprehensive and integrated approach to care.

Building Better Care: The 4Ms Framework in Age-Friendly Health Systems

The John A. Hartford Foundation has pioneered an age-friendly framework to enhance health outcomes for older adults across diverse settings (Institute for Healthcare Improvement, 2020). Age-friendly health systems are characterized by essential evidence-based practices and a person-centered approach. The Institute for Healthcare Improvement, which assists in health system strengthening, uses the Model for Improvement as a guiding framework for quality improvement initiatives (Institute for Healthcare Improvement, 2023). This model, adaptable to existing organizational change frameworks, facilitates accelerated improvement in age-friendly health systems.
One key component of the age-friendly approach is the 4Ms framework, which emphasizes four crucial elements guiding healthcare interactions with older adults: What Matters, Medications, Mobility, and Mentation (Fulmer & Berman, 2019). These elements underscore the importance of individualized assessments covering the 4Ms, which shape personalized care plans tailored to each older adult’s unique needs and preferences.

Toward Integrated Well-being: Breaking Down Silos for Older Adults

By embracing age-friendly practices, addressing social determinants of health, and integrating behavioral and physical health care, we can better serve our older adult population’s multifaceted needs, fostering their overall well-being and quality of life. It is time to break down the silos and provide holistic, person-centered care that acknowledges the interconnectedness of physical, mental, and social aspects of aging. This Mental Health Awareness Month and Older Americans Month, let us recommit to advocating for integrated, age-friendly care that prioritizes mental health and addresses the unique challenges faced by older adults. Together, we can create a healthcare landscape that empowers and supports our aging population, enabling them to thrive in body, mind, and spirit.