One-Third Of Outpatient Behavioral Health Facilities Offer Programs Tailored For Older Adults

May 7, 2026

Most outpatient behavioral health facilities accepted older adults, but only one-third offered programs specifically tailored for adults age 65 and older. Compounding the access problem, less than half of substance use treatment facilities accepted Medicare, compared to about two-thirds of mental health facilities and mixed mental health and substance use treatment facilities. Older adults are also 40% less likely to receive mental health or addiction treatment compared to younger adults, including in specialty settings.

Older adults with behavioral health conditions often have other chronic health problems, including neurocognitive disorders and ongoing physical health problems. Their co-occurring conditions complicate behavioral health treatment and recovery, and the behavioral health conditions increase the risk of further cognitive decline, dementia, and death. Tailored programs are intended to increase access to care by reducing barriers and supporting care coordination.

The report noted that workforce shortages, transportation barriers, fragmented care systems, and the limited availability of geriatric behavioral health specialists continue to affect access to care for older adults.

The findings are based on an analysis of the 2023 National Substance Use and Mental Health Services Survey (N-SUMHSS) responses from 4,986 outpatient substance use treatment facilities, 3,690 outpatient mental health facilities, and 7,898 mixed mental health and substance use treatment facilities. The N-SUMHSS is an annual survey of behavioral health facilities registered and listed in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) inventory of treatment facilities. The survey focuses on what facilities offer; data on consumer utilization is not collected.

• Substance use treatment facilities: 97% accepted older adults, 44% accepted Medicare, and 33% offered programs tailored for older adults
• Mental health facilities: 81% accepted older adults, 67% accepted Medicare, and 35% offered programs tailored for older adults
• Mixed mental health and substance use treatment facilities: 96% accepted older adults, 66% accepted Medicare, and 46% offered programs tailored for older adults

By the type of insurance accepted, the share of facilities offering tailored outpatient programs for older adults ranged from 47% among private facilities that provide mixed care and accept private insurance and Medicare to 32% among substance use treatment provider organizations that also accept Medicaid.

Programs that offered treatment for co-occurring mental health and substance use conditions were more likely to also provide tailored programs for older adults compared to facilities without such programs. Among facilities offering treatment for co-occurring conditions, more than half offered tailored programs for older adults, including 58% of mixed facilities, 57% of mental health facilities, and 58% of substance use treatment facilities.

By profit structure for all facility types, the odds of having tailored programs for older adults were higher among private for-profit facilities relative to publicly owned facilities. Among private for-profit facilities, 55% of mixed facilities, 42% of mental health facilities, and 34% of substance use treatment facilities offered programs tailored for older adults. By comparison, less than one-third of private non-profit mental health and substance use treatment facilities offered tailored programs for older adults. About 41% of private non-profit mixed facilities also offered tailored programs for older adults.

The findings were reported in Availability Of Care For Older Adults In Outpatient Behavioral Health Facilities by the Office of Behavioral Health, Disability, and Aging Policy within the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. The research was conducted by Mathematica. The researchers examined the availability of care for older adults in outpatient behavioral health facilities across the United States. The report does not identify common elements of a tailored program for older adults with mental health and/or substance use disorders.

A link to the full text of Availability Of Care For Older Adults In Outpatient Behavioral Health Facilities is in the OPEN MINDS Circle Library.

For more information, contact: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 200 Independence Avenue Southwest, Room 415F, Washington, District of Columbia 20201; 202-690-7858; Email: media@hhs.gov; Website: https://www.hhs.gov/