Supervisors look to expand mental health access for older adults
SAN JOSE – Continuing to push for improved access to mental health services for older adults, the Santa Clara County Board of Supervisors unanimously supported a series of recommendations from the County’s Behavioral Health Department. The recommendations include enhancing existing safety net programs, expanding suicide prevention efforts, and improving wait times for cognitive assessments.
“Our older adult population is growing fast,” said County Supervisor Joe Simitian. “That makes it even more important that we find better ways of getting folks connected to the mental health services and programs they need. I look forward to seeing a workplan before the end of the year showing how we can implement these improvements.”
In November 2023, Simitian and Board President Susan Ellenberg asked County staff to analyze existing services for older adults, identify the unique needs of older adults and the barriers they face when looking for care, and provide recommendations to close any gaps identified in this resulting report.
By 2030, adults aged 65 years and older will make up 20% of the County’s population. According to a 2019 report from the County’s Department of Aging and Adult Services, by 2035 older adults will outnumber children in the County for the first time, five years sooner than the nation as a whole.
Older adults experience unique challenges as they age. Life changes, such as managing serious illness or the loss of loved ones, can impact mental health. Loneliness, grief, and social isolation can affect even those with support and resilience, and lead to depression and anxiety.
Symptoms from illnesses such as thyroid disease, diabetes, and cognitive impairments may mimic symptoms of mental illness. This highlights the importance of healthcare providers making accurate diagnoses and connecting older adults to appropriate treatment.
Social stigma around mental illness, system complexity, high suicide rates, affordability of care, and access challenges are among the identified barriers older adults face when looking to address mental health care.
The report outlines several options the County could take to better address the mental health care needs of older adults, including:
Adding 18 Skilled Nursing Facility (SNF) beds with behavioral health expertise to the Valley Health Center in Morgan Hill to help address the facilities shortage identified in the report. There are currently no skilled nursing facilities in the County with specialized treatment beds for adults with behavioral health needs.
Expanding suicide prevention efforts for older adults, recognizing that older adults have some of the highest suicide rates in the County, and are more likely to use lethal means.
Evaluating and exploring the enhancement of existing older adults safety net programs, including the Access to Technology program, which helps older adults get connected to the internet and could be a tool to help reduce feelings of isolation and increase access to care through telehealth, particularly for those who face mobility challenges.
Improving access for patients served by the Behavioral Health Services Department, including further analyzing the right mix of field-based, telehealth, and in-person appointment services (as well as other support services like transportation) that are needed to support older adult patients.
Evaluating and identifying ways to improve wait times for cognitive assessments for Santa Clara Valley Health patients to help them receive an accurate diagnosis and treatment referral more quickly. Such assessments are important because some cognitive impairments and diseases in older adults can mimic mental health conditions.
Increasing training for staff working with older adults to better equip staff to identify potential mental health concerns in their clients and connect them to appropriate resources, including resources that can assist them in accessing Medicare financial assistance.
Partnering with the state to address workforce shortages and mental illness stigma, which can be a particular barrier for older adults seeking services.
A key component in these efforts will include exploring options to bring resources and services to places where older adults already gather or seek services – such as senior centers and senior nutrition program sites – in an effort to overcome barriers to access.
“Our County has long provided and supported critical mental health programs and services dedicated to the needs of older adults,” said Simitian. “The challenge now is stepping up and improving that effort. How can we reduce wait time or increase staff training? How can we establish the right partnerships – on the local and state level – to improve access?”
At Simitian’s request, a plan to implement these recommendations is expected to return to the Board before the end of the year. To download a PDF of the report, please visit the following link (Item #18).