Mental Health and Wellness for Older Adults: Counselors Are Prepared to Serve

For many years, NBCC has highlighted the critical need for counselors and marriage and family therapists (MFTs) to be recognized as covered providers for Medicare. Counselors are prepared to meet the needs of clients across the life span, especially now that older adults are facing more intense stressors and concerns than ever before. It is essential to the profession that health coverage providers, as well as other major health care programs, including Medicaid, Tricare, Veterans Health Administration (VHA), the Indian Health Service, and Blue Cross Blue Shield, recognize the value of the services provided by the more than 250,000 counselors and MFTs.

The Help Is Necessary

Medicare is the largest health care program in the United States with over 60 million beneficiaries. Medicare beneficiaries experience a wide range of challenges impacting their mental health, including social isolation, chronic illness, poor nutrition, and cognitive impairment. For many adults, aging corresponds with reduced mobility, which in turn may present limitations to engagement with others. Limited engagement can ultimately lead to feelings of isolation and despair. This social isolation has only been further heightened in the last year and half as the world has dealt with the COVID-19 pandemic. For older adults, this isolation and the resulting depression has starkly affected their mental health and well-being.

Unfortunately, there are limited options for receiving care from qualified professionals, leaving Medicare beneficiaries further debilitated. For older adults in rural communities, access to mental health services is even less accessible. However, counselors and MFTs could help and are ready to bridge this gap.

Counselors Are Prepared to Serve

With the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) setting forth core standards requiring that graduate programs provide counselors-in-training with learning opportunities focused on development across the life span, integrated health teams, and social determinants of health, counselors are uniquely prepared to meet the needs of the older adult population. These standards help to ensure that counselors understand the specific stage of life concerns impacting older adults.

• Standard F.3.i. articulates the critical importance of promoting resilience, health, and wellness across the life span, holding at its core the requirement that counselors understand the developmental phases of the human life span within the context of the social constructs and systems impacting that development.
• Standard F.1.b speaks specifically to the requirement that counselors be prepared to work with integrated behavioral care systems and interagency care teams. By ensuring that counselor preparation includes training to work with integrated, interdisciplinary teams, counselors are better prepared to meet the needs of older adults who have multifaceted health needs.
• Standards F.2.d, F.2.h., and F.3.f all highlight the intersection of social and systemic factors that impact health and wellness. The learning opportunities afforded by these standards ensure that counselors have the opportunity to develop essential knowledge and core competencies in these areas.

Counselors Care

Joel Miller, former Executive Director and CEO of the American Mental Health Counseling Association, notes that counselors have been advocating for the ability to serve Medicare beneficiaries for more than a decade. Miller himself has been intensely engaged in the legislative advocacy work around the Mental Health Access Improvement Act, meeting with NBCC and other members of the Medicare Mental Health Workforce Coalition (MMHWC), and congressional staffers to build support for the legislation.

Miller highlighted the passion for helping this population that counselors have brought to this advocacy. “Counselors are increasingly playing a vital role in the wellness of communities and advocating for the interests of the nation’s health because they are primary mental health providers with a focus on integrated care,” said Miller. He added, “Counselors positively impact the growing concerns of older adults about substance use and opioid addiction, the swelling rates of PTSD diagnoses, the impact on families, the burden that untreated mental health disorders place on medical resources, and other behavioral health issues.” As resiliency-focused, wellness-driven professionals, counselors are eager to assist older adults in navigating resources and building valuable networks of support. 

The preparation of counselors, the passionate willingness to serve that counselors evidence, and the inescapable reality that counselors and MFTs make up 40% of the overall mental health workforce leave us faced with the clear need to include counselors and MFTs as covered providers for Medicare. Counselors are primary mental health providers serving on the front lines of our behavioral health care system and act as first responders in addressing the needs of older adults with anxiety and depressive disorders; trauma-related disorders, such as PTSD; substance use; and other mental health conditions.

If you, too, feel passionate about this work, please reach out to your senators and representatives and urge them to support S. 828/H.R. 432 the Mental Health Access Improvement Act. You can make an easy connection to voice your support through NBCC’s Grassroots Action Center: votervoice.net/NBCCGrassroots/Campaigns/63024/Respond.