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How New York is prioritizing mental health care for elders


The pandemic brought a lot of attention to the mental health of young people. But many older people also struggle with loneliness, anxiety and substance abuse. And many don't get the care they need, as Ashley Milne-Tyte reports.

ASHLEY MILNE-TYTE: There are lots of reasons why older adults have less access to mental health care. Regina Koepp is a clinical psychologist based in Vermont and the founder of the Center for Mental Health and Aging.

REGINA KOEPP: One reason is that professionals are undertrained to treat the mental health needs of older adults. Many professionals feel quite incompetent and will say that they just don't treat older adults.

MILNE-TYTE: Leaving would-be clients scrambling. Then there's cost. Medicare doesn't reimburse all types of mental health provider, such as counselors, and many providers don't work with insurers. And, Koepp says, stereotypes about aging can also interfere with care.

KOEPP: There's an idea that depression is normal with aging or anxiety is normal with aging, when, in fact, these conditions are not normal with aging.

MILNE-TYTE: And can be treated. Koepp says older people benefit greatly from therapy. But sometimes you have to be subtle about the approach because the words mental health still carry plenty of stigma for older generations. New York City has one of the largest and most diverse older adult populations in the country. Lorraine Cortes-Vazquez is commissioner for the New York City Department for the Aging.

LORRAINE CORTES-VAZQUEZ: When you're looking at mental health, you've got to bring all of that perspective into the conversation because, you know, there's some cultures that are more risk averse to mental health services.

MILNE-TYTE: So she says the city is bringing mental health services to older people, where many of them are in senior centers, even if the services aren't always labeled that way.

TANZILA UDDIN: So we are just following up to our leading with intention, the gratitude journaling workshop that we did last week. And today we're going to talk about more self-reflection.

MILNE-TYTE: Social worker Tanzila Uddin is holding the second of two workshops on journaling and gratitude at this senior center in Queens. About a dozen men and women from various ethnic backgrounds are here from their 60s to their 90s. The Department for the Aging has found workshops like this are a way of getting older people to open up on everything from their physical health to depression to problems with bossy adult children.

UNIDENTIFIED PERSON: It's a different generation, different thoughts, different than me.

MILNE-TYTE: Toward the end of her workshop, this 92-year-old man tells Uddin he'd like to talk about his relationship with his son privately. She agrees and reminds everyone this is an option.

UDDIN: You can always come in. You can make an appointment. We'll sit down. We'll be totally private, and we can really connect on what's happening.

MILNE-TYTE: In the last few years, the Department for the Aging has expanded this model of care to 88 senior centers across New York City. It's free to seniors. But things are different in the private market. Susan Ford lives in San Francisco. She's 76, and most of her income comes from Social Security.

SUSAN FORD: I was really in a place of needing something that was very affordable.

MILNE-TYTE: She's getting a reduced rate, working with a therapist in training, a master's degree student at a local university. She says working through the challenges of this phase of her life has been hugely helpful. Ford says every older person deserves the same opportunity.

FORD: If we don't have care that will help us, society is asking us not to be as alive as we can be.

MILNE-TYTE: She says human beings never stop growing whatever their age.

For NPR News, I'm Ashley Milne-Tyte.

(SOUNDBITE OF REVEREND BARON'S "INTERLUDE") Transcript provided by NPR, Copyright NPR.

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Ashley Milne-Tyte