Integrated behavioral health care for older adults

The "Practice Guide: Integrated behavioral health care for older adults" (PDF) provides primary care practices with actionable, evidence-based guidance on the nuances of integrated care for the behavioral health needs of older adults.

This is part of AMA’s broader efforts to empower health care organizations to overcome obstacles to accessible and equitable treatment for their patients’ behavioral, mental and physical health needs.

Changes to physical health can be a normal part of aging, but this is not true of symptoms such as insomnia, low mood, increased suicidal thoughts, memory impairment, and increased substance use or misuse. This patient population also tends to keep their concerns to themselves and may be reluctant to seek help or may even self-identify their symptoms as a normal part of aging.

Additionally, the U.S. health care system is already stretched to meet the need of this population. Not only are there already shortages of primary care physicians and psychiatrists, but also those physicians with specialization in caring for older adults—geriatricians and geriatric psychiatrists.

Creating a treatment pathway (i.e., screening to treatment) for behavioral health concerns when caring for older adults in a primary care setting (both urban and rural) is of utmost importance and highlights the importance of integrated behavioral health care.

In this guide, primary care physicians and their care teams will learn how to include the following best practices into their processes and procedures to integrate behavioral health in the treatment of adults over the age of 65:

1. Identify the most common behavioral health conditions and symptoms.
2. Learn how to implement screening for conditions utilizing history gathered, family member or caregiver information, possible medical tests and more.
3. Consider holistic approach to treatment including both non-pharmacological interventions and medication management.
4. Explore ways to partner with patients as well as engage with any family/friends/caregivers.
5. Measure success and adjust as the evidence presents itself.
6. Access resources to support this population or to delve further into strategies for implementing behavioral health integration into your practice.

Download the AMA's "Integrated behavioral health care for older adults" (PDF) practice guide to learn more.

Please also check out the BHI Collaborative’s Behavioral Health Integration Compendium, which serves as a tool to help provide health care organizations with a proven pathway for delivering integrated behavioral care and ensure they have the most recent, actionable information at their disposal.

• BHI webinar series  
• AMA STEPS Forward® toolkit "BHI Into Primary Care"
• Compendium of BHI resources for physician practices
• BHI in physician practices
• Strategic behavioral health guides for patient care

With an increased number of people reporting worsening mental health in recent years, it is imperative that people are aware of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) telephone program.

People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. The national hotline is available 24 hours a day, 7 days a week.

The previous National Suicide Prevention Lifeline phone number (1-800-273-8255) will continue to be operational and route calls to 988 indefinitely.