{'fraction_non_alphanumeric': 0.03166783954961295, 'fraction_numerical': 0.018296973961998593, 'mean_word_length': 5.061833688699361, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?

This chapter presents the objectives, scope, and context for this report and describes the approach that the Institute of Medicine (IOM) Committee on the Mental Health Workforce for Geriatric Populations used to undertake the study. The committee’s charge was twofold: first, to determine the mental health and substance use (MH/SU) needs of the 65 and older population and, second, to develop recommendations for ensuring a competent and sufficient workforce to meet these needs. This study was undertaken during a period characterized by considerable uncertainty regarding the future organization and financing of the U.S. health care system, dramatic change in the makeup of the older population, and great concern about the capacity of the nation’s mental health and substance use workforce to meet the needs of older adults. Federal responsibility for geriatric MH/SU is diffused among numerous U.S. Department of Health and Human Services agencies, and the agencies’ attention to these concerns is minimal and dwindling. The aging of America has and will continue to have profound consequences for the nation’s economy and society for years to come. The U.S. Census Bureau projects that the number of adults age 65 and older will increase from 40.3 million to 72.1 million between 2010 and 2030 (Vincent and Velkoff, 2010). During the same period, the ethnic, racial, and cultural makeup of the older adult population will become more diverse than ever (Cummings et al., 2011; Vincent and Velkoff, 2010). The impact on the demand for and cost of health care will be unprecedented. In 2008, the Institute of Medicine (IOM) issued a report, Retooling for an Aging America: Building the Health Care Workforce, which highlighted the urgency of expanding and strengthening the geriatric health care workforce to meet the demands of our rapidly aging and changing population (IOM, 2008). The following year, because of similar concerns about geriatric mental health and substance use (MH/SU) needs, Congress mandated that the IOM undertake a complementary study focusing on the geriatric MH/SU workforce needs of the nation (U.S. Congress House of Representatives, 2009). Thus, in response to the congressional mandate, the IOM entered into a contract with the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services (HHS) in September 2010. The IOM Committee on the Mental Health Workforce for Geriatric Populations was appointed in early 2011 to carry out the charge. The 16-member committee included experts in geriatric psychiatry, substance use, social work, psychology, and nursing; direct care workers; and those with specialties in epidemiology, workforce development, labor economics, long-term