An estimated one in eight older adults had a mental illness and one in 11 had a substance use disorder in the past year according to a new report on mental health and substance use concerns among older adults (adults aged 60 or older).

The report, “Behavioral Health Among Older Adults: Results from the 2021 and 2022 National Surveys on Drug Use and Health,” from the Substance Abuse and Mental Health Services Administration, finds that among older adults

• 12.5% had any mental illness in the past year (including about 2% with serious mental illness).
• 12.4% smoke cigarettes.
• 12.8% reported binge alcohol use*.
• 9.9% reported marijuana use (including 12.5% of men and 7.5% of women).
• 9.1% had a substance use disorder, including 5.6% with an alcohol use disorder (5.6%) and 4.1% with a drug use disorder.

Older adult females were more likely than males to have a mental illness; males were more likely than females to have a substance use disorder. The report also highlights that a significant portion of older adults needing behavioral health treatment are not receiving it. Among those with any mental illness, about 46% received treatment. Among those who needed treatment for a substance use disorder, less than one in three (30%) received treatment in the past year.

A variety of factors may contribute to older adults’ increased risk for mental health concerns and may hinder access to care. Medical conditions associated with aging, significant life changes and losses, and social isolation may contribute to mental disorders. Additionally, as adults age, they may be more sensitive to substances. Stigma, cost, transportation and difficulties with the health care system may pose barriers to accessing care.

The significance and pervasiveness of loneliness was highlighted in the U.S. Surgeon General’s 2023 report. In a recent study, researchers at the Indiana University School of Medicine looked at the relationship between loneliness and physical and mental quality of life among older adults. They examined a large sample of older adult patients in primary care settings and found that loneliness was significantly associated with both lower mental and physical quality of life. In addition, “loneliness remained significantly associated with worse mental quality of life after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety.”

The concern about the impact of loneliness relates to this year’s theme for Older American’s Month this May: “Powered by Connection.” The theme encompasses and emphasizes multiple types of supportive connection, including connecting with friends and family (in person and online), connecting with community (such as through classes, community centers or faith organizations); and tapping into the physical and mental health benefits of connection with pets.

The study authors suggest that primary care clinicians should take an active role in discussing loneliness with their older adult patients and providing resources to help patients develop and maintain meaningful social relationships.

* Binge drinking means consumption of four or more drinks on the same occasion for females and five or more drinks on the same occasion for males on at least 1 day in the past 30 days.