Barriers to Mental Health Care for Older Adults

May 08, 2025

More than one in four U.S. adults age 65 or older report having a diagnosed mental health condition or experiencing isolation and/or emotional distress; yet many did not receive care from a mental health professional, a new survey found.

The survey, by the Commonwealth Fund, examined barriers to behavioral health care for older adults in the U.S. and nine other countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweeden, Switzerland, and the United Kingdom.

Here are a few key takeaways:

• Stigma a challenge:  Stigma was overwhelming the top barrier to care across the 10 nations with more than six in 10 older adults reporting that they did want or need to see a health care professional.
• Cost and access:  Among older adults in the U.S., 13 percent said they did not receive care because they couldn’t afford it, could not (or did not know how to find) an appropriate provider, or the wait for care was too long (compared with fewer than 10 percent across all countries).
• Challenges for older adults:  Among U.S. older adults, 19 percent reported having a diagnosed mental health condition, 17 percent reported emotional distress, and 6 percent reported feeling lonely or isolated.
• Risks for older adults:  In the U.S., adults 75 and older have the highest suicide rate among all age groups.
• Medicare opportunities and challenges:  Medicare and Medicare Advantage cover inpatient and outpatient mental health care and prescription drugs and payment changes last year expanded access to more types of behavioral health providers, supporting community-based care. But access continues to be limited by gaps in Medicare coverage, such as inpatient day limits, inadequate provider networks, and lack of coverage for serious mental health needs.

More information about the survey is available online.

HAP has made addressing the unique needs of older adults a key focus of our behavioral health advocacy and is partnering with Area Agencies on Aging, Leading Age, and other stakeholders identify opportunities to expand access to behavioral health care for nursing facility residents. For more information about addressing the behavioral health challenges of older adults, see HAP’s comments on Pennsylvania’s aging roadmap.