Mental health challenges are becoming a growing public health concern among older adults, often exacerbated by the misuse of substance abuse, according to a federal behavioral health agency.

Recent data from the 2021 and 2022 National Surveys on Drug Use and Health revealed one in five older adults had experienced a mental health condition, substance use disorder or both in the previous year. The report also noted that one in eight older adults had used illicit drugs in the past year, one in 11 had a substance use disorder, and one in eight had experienced mental illness in the preceding year. 

More alarming, according to the report, was that less than 40% of older adults who needed substance use treatment or who had mental illness did not receive treatment. The Substance Abuse and Mental health Services Administration said that those numbers underscore the need for targeted mental health services for the aging population.

To address issues related to older adults not receiving appropriate diagnoses and care, SAMHSA’s report, “Supporting the Mental Health Needs of Older Adults,” highlighted evidence-based practices effective in addressing mental health challenges faced by older adults, including psychosocial interventions tailored to the unique needs of the older population.

The report noted that behavioral health integration efforts require care that spans a variety of providers and systems, including long-term care facilities, aging services providers, home care providers and other specialty medical services. Integrating behavioral and physical healthcare is one of five priority areas in SAMHSA’s strategic plan.

“Behavioral healthcare is a vital component of the overall health and well-being of older adults, and there is a demonstrated need to expand mental health services and systems to meet the unique needs of this population,” the report concluded. “States have a role in expanding access to critically needed evidence-based services and supports for older adults through behavioral health integration efforts and policy development that promotes the use of such practices and programs.”

Meanwhile, a recent study in JAMA Network Open from researchers in California found that cannabis use disorder in older adults was close to the prevalence of tobacco use and carried the same risk factors.

In a cross-sectional study of 4,500 older veterans receiving treatment from the Veterans Health Administration, 10% reported past 30-day cannabis use, 36% of whom had cannabis use disorder. Odds of cannabis use disorder were higher among younger respondents, those reporting anxiety, those with one or more limitations of activities of daily living, those with past month illicit drug use, and those with frequent, inhaled or recreational cannabis use. 

The researchers said that the number suggests that cannabis use was twice as high in the veteran population compared with older adults in the general population. Cannabis on a daily or nearly daily basis was common among the veteran population, with more than one-third showing at least mild cannabis use disorder. 

“Given rapid cannabis legalization affecting rates of use and cannabis use disorder, and increasing social acceptance of cannabis use, more focus is needed on negative health consequences of cannabis use in older veterans, such as higher risk for cardiovascular and respiratory outcomes, neuropsychiatric disorders, and development of cannabis use disorder,” the authors stated. 

Their findings also highlighted the importance of screening older veterans for cannabis use and reinforcing efforts to prevent its misuse in older adult populations, they said.