3 Barriers Preventing Older Adults from Seeking Treatment for Depression

May is Mental Health Awareness Month — a time to spotlight the challenges older adults face and the changes we can make.

As people age, they often face a mix of life changes — like chronic health issues, loss of loved ones, reduced independence, or social isolation — all of which can increase the risk of depression.

But many older adults suffer in silence due to barriers that make it hard to recognize, diagnose, or treat the condition.

Below are three major reasons older adults may not seek therapy for depression — and some hopeful solutions that could change the future of mental health care for older adults.

1. A Shortage of Professionals

There simply aren’t enough mental health professionals trained to care for older adults.

Back in 2002, the U.S. had 106 doctors doing advanced training in the mental health needs of seniors — they’re called geriatric psychiatry fellows.

By 2023, that number had dropped to just 48.

Only about 1% of licensed psychologists specialize in working with older adults.

In rural areas, the situation is even worse — many communities don’t have a single psychiatrist. And half of the programs meant to train geriatric doctors sit empty.

2. High Costs and Limited Insurance Coverage

Mental health care shouldn’t feel out of reach — but for many older adults, it still does.

A survey from The Commonwealth Fund found that U.S. Medicare beneficiaries have some of the highest mental health needs among older adults in high-income countries — but they’re also more likely to skip or delay care because of the cost.

While Medicare does provide important financial protections, many older adults still face high out-of-pocket expenses—especially those with serious mental health concerns who tend to use more health services.

These high costs often force people to postpone care or avoid it altogether, which can lead to worse health outcomes and higher overall costs.

And even when someone is ready to get help, they might struggle to find a provider who accepts Medicare.

In a 2023 forum on mental health care for older adults, experts raised concerns that the number of psychiatrists accepting Medicare is declining, leaving millions of older Americans without adequate mental health support.

Lauren Gerlach, a geriatric psychiatrist at the University of Michigan, points out that many mental health providers don't accept Medicare because of low reimbursement rates.

3. Stigma and Misunderstanding

Many older adults — and their families — still carry harmful beliefs about mental illness.

• Depression is sometimes dismissed as just a phase or a normal part of aging.

• It can be seen as a personal weakness or something to be ashamed of.

• Some worry they’ll be labeled as “crazy” or judged by their community.

These beliefs prevent people from seeking the help they need.

When we dismiss or minimize mental health struggles, people stop reaching out — and more seniors are left suffering in silence.

Changes We Can Make

Stephen Bartels, director of the Mongan Institute, suggests that to address the shortage of mental health professionals, we can turn to mental health counselors, community health workers, and even trained non-licensed professionals.

Expanding access through telehealth is also a good direction to head to so more people can get support from the comfort of home, especially in rural areas.

And there’s momentum in policy, too.

AARP highlighted the Mental Health Access Improvement Act of 2021 could open the door to 225,000 more mental health providers for people on Medicare — a huge leap in the right direction.

Most importantly, we need to keep saying it — out loud and often:

Depression is NOT a normal part of aging.

It’s treatable.

It is not a personality flaw.

And there is no shame in asking for help.

In fact, more than 80% of older adults with depression recover when it’s properly diagnosed and treated with medication, therapy, or both.

We need more voices — from everyday people to public figures — speaking up to break the silence and end the stigma around depression.