Prioritizing the mental health needs of seniors

The fight over how to achieve real healthcare reform continues to be hotly debated. From Washington to the West Coast and all the communities in-between, American citizens and elected officials are still debating the effectiveness of the Affordable Care Act as well as whether it should be repealed, replaced or promoted. Clearly, access and delivery of healthcare continues to cause passionate conversations. 

In these large political fights, it is difficult to find an area where lawmakers can come together in a bipartisan manner and make real improvements to our healthcare system for those who are in great need of care. However, if you look hard enough, you can see some signs of progress.  

Late last year, Reps. Chris Gibson (R-N.Y.) and Mike Thompson (D-Calif.) introduced H.R. 3662, the “Mental Health Access Improvement Act of 2013.” If passed, this bill would finally allow Medicare to reimburse Licensed Professional Counselors (LPCs) for treating our nation’s senior citizens. This marks the first time in more than seven years that a Republican has sponsored this bill in the House.   

The American Counseling Association (ACA) is grateful that Gibson and Thompson have introduced this legislation and would like to inform the public of its importance.

If this bill is passed, more than 120,000 LPCs will become available to help those in need of mental health services. If it is not passed, the health of our nation’s senior citizens will continue to be ignored.

The Center for Disease Control (CDC) has stated that depression, “is the most prevalent mental health problem among older adults,” and that depressive disorders can negatively impact the treatment of other chronic diseases. In other words, untreated depression could make chronic medical conditions, such as diabetes much worse for older Americans. In the United States, it was also reported that 15 to 20 percent of adults older than 65 years old have experienced depression, according to the Geriatric Mental Health Foundation.

The CDC also notes that while 80 percent of depressive disorder cases can be treated many of them remain untreated or undertreated in older adults.

Many Medicare beneficiaries live in mental health professional shortage areas. There are more than 120,000 LPCs across the country ready to provide treatment to these underserviced individuals. Lack of access to outpatient mental health treatment harms beneficiaries and contributes to overutilization of more expensive inpatient care. It also increases the costs of treating chronic medical conditions, such as diabetes or congestive heart failure, since many individuals with these conditions have a comorbid depressive disorder.

Medicare coverage of professional counselors is not a partisan issue, nor is it a new issue. H.R. 3662 is a companion bill to S. 562, the “Seniors Mental Health Access Improvement Act of 2013.” This Senate bill was introduced by Sens. Ron Wyden (D-Ore.) and John Barasso (R-Wy.). Also, the Senate passed legislation establishing Medicare reimbursement of LPCs in both 2003 and 2005, during Republican control of that chamber. The House of Representatives has also approved such language twice, in both 2007 and 2009, under Democratic control.

The current shortage of mental health professionals available to Medicare beneficiaries is only going to get significantly worse over the coming years as the Baby Boomers enroll in the program and current mental health service providers retire.

In this current climate, to say that it is rare to have an issue championed by lawmakers from different parties is a gross understatement. Yet here we are with a wonderful example of a Republican and a Democrat working for commonsense reform that could dramatically increase access to mental healthcare for our seniors, particularly those living in rural areas. In some states, LPCs are proportionately more likely to work in rural and underserved areas than clinical social workers, psychologists, and psychiatrists. Unfortunately, they are being restricted from doing just that.

H.R. 3662 also has the power to improve Medicare beneficiaries' access to outpatient mental health care in a cost-effective manner by establishing coverage of highly-qualified LPCs.

Gibson’s and Thompson’s commitment to improving the access of mental healthcare to our seniors is to be commended. We don’t often see elected officials willing to take on an issue without fanfare. Gibson and Thompson have done just that—taking up this fight because they know it is the right thing to do. We hope that the rest of their colleagues follow suit. 

Terrazas is director of Government Affairs for the the American Counseling Association.