makeup of the older adult population will become more diverse than ever (Cummings et al., 2011; Vincent and Velkoff, 2010). The impact on the demand for and cost of health care will be unprecedented. In 2008, the Institute of Medicine (IOM) issued a report, Retooling for an Aging America: Building the Health Care Workforce, which highlighted the urgency of expanding and strengthening the geriatric health care workforce to meet the demands of our rapidly aging and changing population (IOM, 2008). The following year, because of similar concerns about geriatric mental health and substance use (MH/SU) needs, Congress mandated that the IOM undertake a complementary study focusing on the geriatric MH/SU workforce needs of the nation (U.S. Congress, House of Representatives, 2009). Thus, in response to the congressional mandate, the IOM entered into a contract with the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services (HHS) in September 2010. The IOM Committee on the Mental Health Workforce for Geriatric Populations was appointed in early 2011 to carry out the charge. The 16-member committee included experts in geriatric psychiatry, substance use, social work, psychology, and nursing; direct care workers; and those with specialties in epidemiology, workforce development, labor economics, long-term care, health care delivery and financing, and health care disparities.1 Brief biographies of the committee members are provided in Appendix E.

STUDY SCOPE

The charge to the committee was essentially twofold: first, to assess the current and projected MH/SU needs of adults age 65 and older and, second, to recommend how the nation should prepare the MH/SU workforce to meet these needs (Box 1-1). The committee was also asked to address the unique needs of important subgroups in the older adult population, including individuals of diverse ethnic backgrounds, veterans with posttraumatic stress disorder, and persons living with chronic disease. The study sponsor asked the committee to define the MH/SU workforce broadly (Frank, 2011). The committee focused on the full spectrum of workers who are engaged in the diagnosis, treatment, care, and management of MH/SU conditions in older adults—ranging from personnel who may have minimal education to specialty physicians with the most advanced psychiatric and neurological training. This includes

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1 An additional committee member with expertise in the consumer perspective was also appointed, but had to step down from the committee due to illness.



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