Elders with Serious Mental Illness: Lost Opportunities and New Policy Options

Student Author(s)

Richard H. McManus

UMMS Affiliation

Clinical and Population Health Research; Department of Family Medicine and Community Health; Center for Health Policy and Research

Publication Date


Document Type


Medical Subject Headings

Community Mental Health Services; Health Services for the Aged; Home Care Services; Insurance Coverage; Medicaid; Mental Disorders


This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under Medicaid.

Rights and Permissions

O'Connor D, Little F, McManus R. Elders with serious mental illness: lost opportunities and new policy options. J Aging Soc Policy. 2009 Apr-Jun;21(2):144-58. DOI 10.1080/08959420902733090.

Related Resources

Link to article in PubMed

PubMed ID