title: Strengthening psychology's workforce for older adults: Implications of the Institute of Medicine's report to Congress.
abstract: Professional psychology faces an urgent crisis, which the following facts paint in stark relief. Adults over age 65 will rise to 20% of the U.S. population over the next 15 years and already account for a third of the country's health care expenditures. Up to 8 million older adults experience mental health and substance use conditions in a given year, yet most psychologists receive no training in their assessment and treatment. No more than an estimated 4%, or 3,000, psychologists nationwide specialize in geropsychology; a ratio approaching 3,000 to 1. A small group of advocates within the profession have sounded the alarm and worked to strengthen geropsychology as a specialty, but this has had very limited impact on the actual supply of psychologists qualified to provide services to this population. In 2012, an Institute of Medicine (IOM) committee released a report on the crisis regarding the mental health and substance use workforce for older adults. Drawing on that report, a team composed of geropsychologists, along with psychologists who served on the IOM committee, identifies in this article priority areas for workforce development. The authors assess the progress of psychology in each of these areas and offer a set of recommendations for future efforts by this profession to develop its own workforce and to strengthen the ability of other caregivers to address the behavioral health needs of older adults. Strengthening its own workforce and responding to the needs of this population is imperative if psychology is to maintain its relevance as a health profession and meet its ethical obligations to an increasingly diverse society.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hoge
authors.affiliation: Mental Health Services, U.S. Department of Veteran Affairs, Central Office.
authors.forename: Michele J
authors.initials: MJ
authors.lastname: Karel
authors.affiliation: Mental Health Services, U.S. Department of Veteran Affairs, Central Office.
authors.forename: Antonette M
authors.initials: AM
authors.lastname: Zeiss
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance.
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegria
authors.affiliation: VA Boston Healthcare System.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moye
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D035082:Federal Government; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006801:Humans; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011157:Population Dynamics; D011584:Psychology / Q000193:education; D014481:United States; D000078329:Workforce
references.citation: Am Psychol. 2014 May-Jun;69(4):399-408
references.pmid: 24820689
references.citation: Gerontologist. 2002 Jun;42(3):356-72
references.pmid: 12040138
references.citation: JAMA. 1999 Sep 1;282(9):867-74
references.pmid: 10478694
references.citation: Acad Med. 2004 Jul;79(7 Suppl):S3-6
references.pmid: 15240207
references.citation: Am Psychol. 2013 Jan;68(1):32-40
references.pmid: 22889286
references.citation: Int J Geriatr Psychiatry. 2010 Dec;25(12):1230-8
references.pmid: 20104515
references.citation: Gerontologist. 2004 Jun;44(3):426-31
references.pmid: 15197297
references.citation: Med Clin North Am. 2002 May;86(3):641-56, viii
references.pmid: 12168563
references.citation: Community Ment Health J. 2012 Feb;48(1):91-7
references.pmid: 21681459
references.citation: Am Psychol. 2009 Apr;64(3):205-14
references.pmid: 19348521
references.citation: N Engl J Med. 2013 Feb 7;368(6):493-6
references.pmid: 23343039
references.citation: Annu Rev Public Health. 2012 Apr;33:123-35
references.pmid: 22429161
references.citation: Heart. 2011 Mar;97(6):500-5
references.pmid: 21339320
references.citation: Pain. 2011 Sep;152(9):2098-2107
references.pmid: 21683527
references.citation: J Clin Psychol. 2003 Mar;59(3):275-88
references.pmid: 12579545
references.citation: Am Psychol. 2013 Jan;68(1):1-6
references.pmid: 23025748
references.citation: Nurs Outlook. 2011 Jul-Aug;59(4):236-41
references.pmid: 21757081
references.citation: Alcohol Clin Exp Res. 2010 Feb;34(2):262-71
references.pmid: 19951297
references.citation: J Pain Palliat Care Pharmacother. 2015 Jun;29(2):133-9
references.pmid: 26095483
references.citation: Aging Ment Health. 2013;17(5):544-54
references.pmid: 23461355
references.citation: J Am Geriatr Soc. 2013 Aug;61(8):1377-86
references.pmid: 23869899
references.citation: Am Psychol. 2004 May-Jun;59(4):236-60
references.pmid: 15149264
references.citation: J Geriatr Psychiatry Neurol. 2003 Dec;16(4):219-24
references.pmid: 14653430
references.citation: Aging Ment Health. 2007 Nov;11(6):716-21
references.pmid: 18074259
references.citation: Ann Intern Med. 2006 Nov 21;145(10):727-38
references.pmid: 17116917
references.citation: J Am Geriatr Soc. 2007 Oct;55(10):1585-91
references.pmid: 17714458
references.citation: Int J Aging Hum Dev. 2003;57(4):313-37
references.pmid: 15195981
references.citation: Int Psychogeriatr. 2012 Jun;24(6):856-70
references.pmid: 22244371
references.citation: Int Psychogeriatr. 2010 Sep;22(6):886-96
references.pmid: 20149270
references.citation: Health Aff (Millwood). 2013 Nov;32(11):2005-12
references.pmid: 24191093
references.citation: Aging Ment Health. 2012;16(5):625-35
references.pmid: 22304676
references.citation: Gerontologist. 2013 Apr;53(2):345-52
references.pmid: 22936540
references.citation: Diabetes Care. 2013 Sep;36(9):2551-8
references.pmid: 23735726