Primary Care Psychology: An Opportunity for Closing the Gap in Mental Health Services for Older Adults

Older adults, particularly in minority and lower income communities, continue to receive less mental health care relative to the general population. Concurrently, there has been increasing emphasis on the need to integrate mental health services into primary care settings. This push toward integration presents a unique opportunity to help close the gap in mental health services to underserved populations, including older adults. We discuss factors that have influenced this trend and specifically address the role of primary carebased psychologists in treating psychological disorders in older adults. A primary care psychology service at an urban training clinic is described and data are presented on 134 consecutive older adult patients who received services. Finally, two cases are presented to illustrate how integrated care can reach older adults who may not otherwise seek services or would get services only after psychological issues had become more acute. These cases support the view that integrated primary care can serve as a vital, flexible tool for enhancing timely mental health care for older adults, particularly within underserved populations. This population-based approach to providing brief services to a wide range of patients does not eliminate the need for more intensive services provided in mental health care settings but, rather, serves as a complement to those services.