The American Association for Geriatric Psychiatry (AAGP) was, once again, out front fighting for better mental health services for America’s older adults. Last month AAGP convened the first multidisciplinary conference on mental health services in long-term-care facilities. Attendees at the conference—more than 125 people representing many different professions and organizations involved in long-term care—called for immediate and significant changes in the delivery of mental health services to nursing home residents.

The conference, "Providing Optimal Mental Health Services in Long-Term Care," was held in Washington, D.C. For the first time, experts, including psychiatrists, psychologists, nursing home administrators, nursing home medical directors, nurses, pharmacists, consumer advocates, and government regulators, met to reach consensus regarding how to overhaul what all agreed is a broken system.

"Our society is experiencing unprecedented growth in the elderly population and in the number of people who require nursing home care," said William E. Reichman, M.D., president of AAGP and an associate professor and vice chair of psychiatry at the Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey.

"We are witnessing an epidemic of Alzheimer’s disease, and we anticipate a substantial rise in other mental disorders associated with late life as the baby-boom generation ages."

Nursing homes in the U.S. currently care for more than 1.5 million people each year. This number is expected to double in the next five to 10 years. As many as half of all nursing home residents suffer from some sort of cognitive deficit, and some studies indicate that as many as 80 percent of residents have at least one diagnosable psychiatric disorder. Yet fewer than 10 percent of all nursing home residents currently receive any form of mental health services.

"The character of our society," Reichman continued, "should be defined by the care and respect we give to our elderly, to our parents. At this point in our society, our character doesn’t look too good."

Soo Borson, M.D., immediate past president of AAGP and a professor of psychiatry and behavioral health at the University of Washington, Seattle, added, "The goal of this conference is for all of us, from our many different professional roles, from our many different points of view, to come to consensus on what needs to be changed in the culture of long-term care."

Borson cochaired the conference with Reichman and Jules Rosen, M.D., a professor of psychiatry at the University of Pittsburgh.

The conference included presentations by some of the industry’s most noted experts. Discussion included the epidemiology of mental health disorders in nursing homes, organizational and staffing issues in long-term care, mental health interventions in nursing homes, and policy implications from both the research and payment perspectives.

The comprehensive conference was the collaborative effort of the AAGP, APA, American Psychological Association, American College of Health Care Administrators, American Society for Consultant Pharmacists, and the National Association of Directors of Nursing Administration.

The conference steering committee hopes to prepare, within the next three months, a consensus statement on model best practices for the delivery of mental health services in nursing homes. In addition, the committee is working on a public education campaign to empower consumers on how to evaluate nursing home care. The committee is also exploring a coalition approach to advocating for increased funding for research and changes in reimbursement policies, including the 50 percent copayment under Medicare for treatment of psychiatric disorders.