The Geriatric Scholars Program: Expanding the workforce equipped to care for the mental health needs of older Veterans

Abstract:In 2023, approximately 50% of the US veteran population was aged 65 or older, in comparison to 17% in this age cohort in the general US population. Older veterans have higher prevalence rates of substance use disorders than the general older adult population, though rates of mental health problems such as depression, anxiety, posttraumatic stress disorder (PTSD), and major neurocognitive disorder are largely consistent in the two groups. Of particular concern are the comorbid physical and mental conditions among older veterans associated with increased health care utilization, increased costs, and poorer patient outcomes. While access to mental health services has improved, significant concerns remain, as older veterans are less likely to receive these services than their younger counterparts. On the patient side, underreporting of symptoms due to stigma, negative perceptions of mental health challenges, and low mental health literacy may lead to lower receipt of services. On the provider side, atypical manifestations of mental health disorders can lead to inaccurate or overlooked diagnoses, which are further impacted by gaps in provider training. The main systemic barrier to improved mental health services for older adults is the seemingly insurmountable workforce shortage. The National Center for Health Workforce Analysis’ 2023 report underscores that the US behavioral health workforce shortage is expected to worsen over the next few decades. The US Department of Veterans Affairs (VA) reports similar severe staffing shortages in psychologists and psychiatrists. Rural-dwelling, older, and minority veterans are most impacted by these staffing shortages. The Veterans Health Administration (VHA) has invested in developing the skills to care for this older veteran population for its primary care workforce through the Geriatric Scholars Program (GSP), a longitudinal, multidisciplinary training program targeting frontline providers in primary care, rehabilitation, and mental health settings. This article describes the development, implementation, and 3-year evaluation of programs for psychologists and psychiatry providers.