Academic journal article Journal of Mental Health Counseling

Older Adults and Integrated Health Settings: Opportunities and Challenges for Mental Health Counselors

Academic journal article Journal of Mental Health Counseling

Older Adults and Integrated Health Settings: Opportunities and Challenges for Mental Health Counselors

Article excerpt

The growing number of older adults and the increasing recognition and growth of integrated health teams are creating expanded career opportunities for mental health counselors (MHCs). Collaborative integrated teams, staffed with medical personnel and MHCs, can provide comprehensive patient-centered care that addresses client issues from a hiopsychosocial perspective. However, working with older adults on an integrated health team or in an interdisciplinary setting presents unique challenges and raises ethical issues. The evolving opportunities and strategies to address accompanying challenges are highlighted so that MHCs can be prepared to work effectively with older adults in interdisciplinary settings and on integrated health care teams.


America is graying both literally and figuratively as baby boomers live longer due primarily to medical advances that have transformed previously life-threatening diseases into treatable chronic conditions (Centers for Disease Control and Prevention (CDC) National Center for Chronic Disease Prevention and Health Promotion, 2011; CDC & Merck Foundation, 2007). These baby boomers are transitioning into the phase of life termed "older adults," those who are 65 and older (U.S. Department of Health and Human Services, Administration on Aging, 2013). By 2030 the number of older adults in the United States is projected to more than double, to about 71 million, or about 20% of the U.S. population (CDC & Merck, 2007).

The Institute of Medicine (IOM, 2012) reported that a growing older population "holds profound consequences for the nation" (p. 1). For example, one in five older adults in the United States has one or more mental health and substance abuse conditions that are typically comorbid with other health problems and often inadequately met in the current health care system (IOM, 2012). As older adults represent a larger proportion of the population, there will be a corresponding increase in the need for mental health care. Yet the number of mental health professionals working in or entering fields related to geriatric mental health or substance use is in short supply (IOM, 2012).

These alarming statistics raise the question: Who will provide the health services these older adults will surely need? The American Psychological Association (APA) Presidential Task Force on Integrated Health Care for an Aging Population (2008) recognized that one effective answer is integrated health care teams in which mental health professionals work collaboratively with medical professionals to treat older adults holistically. Noting that many of the current integrated health care practices include social workers and psychologists, Bowling Aitken and Curtis (2004) urged mental health counselors (MHCs) to "aggressively seek ways to enter this promising market" (p. 329). Given the rising numbers of older adults and the urgent need to take better care of them, MHCs should step up and join with other health professionals to provide them with comprehensive, integrated health care that addresses their physical, emotional, and interpersonal needs.


Interest in integrated health care has evolved as Western medicine increasingly recognizes how the connection between the mind and the body affects prevention and development of diseases. After studying the interplay of biological, behavioral, and societal influences on health and disease, the IOM (2001) reported that health and disease are determined by dynamic interaction of biological, psychological, behavioral, and social factors. It recommended that more resources be directed to interdisciplinary research and intervention studies that integrate biological, psychological, behavioral, and social variables. The integrated health care model meets this recommendation because it considers the biological, psychological, and social (biopsychosocial) processes in an integrated and interactive approach to evaluate and treat physical health and illness (Sills & Rothman, 2004). …

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