Health Policy Brief January 2019 California’s Behavioral Health Services Workforce Is Inadequate for Older Adults Janet C. Frank, Kathryn G. Kietzman, and Alina Palimaru SUMMARY: The Workforce Education and Training component of California’s Mental Health Services Act, which passed in 2004, has infused funding into the public mental health system. However, funding has not kept pace with an existing behavioral health workforce shortage crisis, the rapid growth of an aging population, and the historical lack of geriatric training in higher education for the helping professions. This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California. The brief offers recommendations to the following specific audiences for improving workforce preparation and distribution: state policymakers and administrators; educational institutions, accrediting bodies, and licensing boards; and county mental health/behavioral health departments and their contracted providers. Older Adult Behavioral Health Care Needs D espite over two decades of reports documenting the inadequate number and preparation of workers trained to serve the unique behavioral health needs of older adults, this critical deficit remains unaddressed. 1, 2 According to a 2012 Institute of Medicine and National Academies Report, “The workforce is not prepared—in numbers, knowledge and skills—to care for the mental health and substance use needs of a rapidly aging and increasingly diverse older adult population.” 1 Unfortunately, this statement mirrors the experience in California, as shown in findings from the 2017 California Mental Health Older Adult System of Care study, 3 as well as in a review of planning activities currently underway at the California Office of Statewide Health Planning and Development (OSHPD) and the California Behavioral Health Planning Council (CBHPC). Older adults have important needs in mental health and substance abuse/misuse (behavioral health) that require a well-trained workforce with geriatric behavioral health expertise in the areas noted below. Suicide Prevention The incidence of suicide is particularly high among older males, and the suicide rate among older white males (ages 85+) is more than four times higher than the overall rate in the nation. 4 Suicide attempts are often more lethal in older adults than in younger adults. Compared to adults under 60 years of age, older adults who attempt suicide are often more frail, more isolated, more likely to have a suicide plan, and nearly twice as likely to use firearms as a means of suicide. 4 Depression and Anxiety Depression is the most common mental illness in late life and decreases quality of life. 5 Nationally, between 8 and 16 percent of community-dwelling older adults have depressive symptoms, and rates are ‘‘ Older adults … require a well-trained workforce with geriatric behavioral health expertise. ’’ Funding for this work and brief was provided by Archstone Foundation.