On October 25, 2000, Senator Paul Wellstone introduced the Medicare Health Modernization Act, the first bill of its kind, to improve the delivery of mental health services through the Medicare health care system. Despite major scientific breakthroughs in the understanding of mental illness, mental health services in the Medicare system have remained virtually unchanged since it was enacted by Congress in 1965. The Wellstone legislation would increase access to mental health services for all Medicare recipients.

“As we work to improve mental health care access for all Americans, we must focus especially on the needs of the ever-growing population of older Americans. We urgently need to bring… mental health care to those in need,” Wellstone said. “In order to receive mental health care, seniors must pay, out of their own pockets, one-half the cost of a visit to their mental health specialist. That is an extremely unfair burden to place on the elderly.”

The Wellstone Medicare Mental Health Bill

* Reduces the co-payment for mental health services from 50 percent to 20 percent, on par with all other health care services under Medicare.

* Adds coverage for intensive residential and home health care for mental illness under Medicare.

* Increases the number of mental health provider groups under Medicare.

Though often not recognized, mental health problems among the elderly are widespread and life-threatening. Americans 65 years and older have the highest rate of suicide of any population. Major depression is also strikingly prevalent among older people, with between 8 and 20 percent of older people in community studies showing symptoms of depression. All too often, depression among the elderly is untreated or inappropriately treated, and this disease and other illnesses such as Alzheimer’s disease, anxiety, late-life schizophrenia, can lead to severe impairment or death.

A broad coalition of advocacy groups, including American Counseling Association, the National Alliance for the Mentally Ill, the National Mental Health Association, the American Psychological Association, the Bazelon Center for Mental Health Law, and the National Association of State Mental Health Program Directors, support Wellstone’s legislation. In addition, the U.S. Surgeon General David Satcher recently recognized the urgency of improvements in treatment of mental illness under Medicare.