Can America Meet the Multiplying Mental Health Care Needs of an Aging Populace?

Article excerpt

As we anticipate the proportion of adults ages 65 and older growing from 12.4% in 2000 to 20% by 2030, the number of older adults with mental illness is expected to double to 15 million. This growing number of oldest-old adults with mental health needs will exacerbate the current shortfall of healthcare providers who have geriatric mental health expertise, raising critical questions about who will care for elders' psychosocial and mental health needs.

The shortage of geriatric social workers was recognized as early as 1987, when it was predicted that 60,000 to 70,000 geriatric social workers would be required to meet older adults' needs by 2020, a projection documented again in 2004. Yet less than 10% of that projection is currently available.

The demand for geriatric social workers will increase 45% by 2015, faster than the average of all other occupations. Geriatric social work ranks as one of the top 20 careers in terms of growth potential. Despite the promising job market, recruiting social workers to geriatrics remains a challenge for the majority of social-work programs nationally.


Such recruitment challenges are intensified by the increasing gap between supply and demand of geriatric social workers. In fact, recent graduates are less likely to work in aging than those who graduated in the 1970s.

In 2001, only 3% of the more than 150,000 members of the National Association of Social Workers (NASW) identified gerontology as their primary area of practice. By 2005, this had increased, but only to 9% of a sample of licensed NASW members. Among these, fewer than 5% were trained in gerontological social work. Yet 75% of this national sample worked in some capacity with older adults and their families - in schools and with child welfare when grandparents are primary caregivers for grandchildren, or in community-based health and mental health clinics.

Because of the small percentage of students who take courses in aging, most in the NASW sample were inadequately prepared to work with older adults. While all social workers may acquire some mental health training, the proportion of social workers prepared specifically for geriatric mental health is unclear. However, given the challenges of recruiting students to geriatric social work, even fewer are likely to specialize in geriatric mental health. Indeed, the majority of mental health curriculum specializations at the graduate level do not include content on older adults.


Other systemic trends are of growing concern. Geriatric social workers, older on average than practitioners in other fields, are nearing retirement age. In 2005, 10% of practitioners with a masters degree in social work and 8% with a bachelors degree in social work reported plans to retire in two years. …