Between 2010 and 2030, unprecedented growth will occur in the elderly 65+ population of the United States. This group will:
- Increase from 40.2 million to 72.1 million persons.
- Expand from 13.1% to 19.3% of the overall population.
- Constitute more than half of our total population growth—31.9 million of 63.3 million persons overall.
Thus, we very reasonably can anticipate that these shifts will lead to major social and cultural changes as well. Because one of every five Americans will be elderly, compared to slightly more than one in 10 now, many more locales in the United States will have the look and feel that Florida does today. This will be particularly true of rural areas, which already have large elderly populations. More of our leaders will be elderly (witness the two Presidential candidates this year). More elderly persons will remain in the workplace into their 70s and 80s, and more enclaves of elderly persons will exist in our urban communities. Our businesses and culture will cater much more to the elderly, because this population group will represent such a large segment of the market, yet many elderly persons also will be poor.
These demographic shifts will have dramatic effects on the prevalence of behavioral health conditions. In 2030, about 18 million elderly persons will have one or more mental illnesses, compared to 10 million elderly persons today. Similarly, about 5.3 million elderly persons will have a substance use condition, compared with 3 million elderly persons today. For each group, the growth in prevalence of these conditions among the elderly will exceed the total number of persons being treated in the public sector for these conditions across all age groups today.
Since the founding of the National Institutes of Mental Health (NIMH) in 1949, and even much earlier, behavioral healthcare has focused upon the care of adults. About three decades ago, care of children also became a focus. Yet, despite the fact that the elderly population already is very large, this group has yet to receive equivalent attention, either in our college and university training courses or in our community care settings.
Today, the elderly population no longer can be ignored by behavioral healthcare. The demographic shifts described above will generate dramatic new demands for care by elderly persons. Without careful planning, we will run the risk of this new demand for behavioral healthcare overwhelming our state, county, and city care systems.
What can be done now to avert this coming crisis?