Mental health problems are common in later life, and they can be treated. Nearly 1 in 5 older Americans lives with a mental health or substance use condition.¹ Yet many older adults never get care, or they are not sure where to start.

This page explains who can help, what a geriatric psychiatrist does, and how a primary care team can bring in mental health care. It also covers free community services and how to reach your local Area Agency on Aging. Phone numbers and rules here are current as of October 2026.

Key points

Your regular doctor is often the best first step. They can refer you to a psychiatrist, psychologist or clinical social worker.²
Geriatric psychiatrists are doctors with extra training in the mental health of older adults. There are not enough of them, so waits can be long.¹
Collaborative care brings a mental health team into your primary care office. Medicare Part B helps pay for it.⁵ In a large study, it more than doubled the success of depression care for older adults.⁶
In Virginia, every Community Services Board (CSB) offers same-day mental health screening, therapy, psychiatry and crisis help.⁸
Area Agencies on Aging connect older adults and families to local support. Find yours through the Eldercare Locator at 1-800-677-1116.^10,11

Who provides mental health care for older adults

Many kinds of professionals can help. Medicare Part B covers outpatient mental health care from all of the people in this table.³

Professional	What they do
Primary care doctor, nurse practitioner or physician assistant	Checks for physical causes, screens for depression, can prescribe medicine and refer you
Psychiatrist	A medical doctor who diagnoses mental illness and prescribes and adjusts medicines
Geriatric psychiatrist	A psychiatrist with an extra year of training focused on older adults
Clinical psychologist	Tests thinking and mood and provides talk therapy
Clinical social worker, counselor, or marriage and family therapist	Provides talk therapy and helps with family and practical problems
Clinical nurse specialist	A nurse with advanced training who may provide therapy or medicine care

You do not always need a specialist. Many people do well with a primary care provider plus a therapist. A specialist matters most when problems are complex, severe or not getting better. To find a therapist, see how to find a therapist. For costs, see what Medicare covers for mental health.

What a geriatric psychiatrist does

Geriatric psychiatry is the branch of medicine that prevents, diagnoses and treats mental and emotional problems in older adults.¹ A geriatric psychiatrist finishes medical school, four years of psychiatry training, and then a one-year fellowship in geriatric psychiatry. Many also pass a board exam in this subspecialty, but it is not required to practice.¹

They work in private offices, hospitals, assisted living, nursing and rehab centers, and veterans' care centers.¹ Two of the most common problems they treat are depression and the behavior and mood changes that can come with dementia.¹

Why see someone with this training? Many older adults with mental health problems also have several long-term physical illnesses. That makes both treatment and caregiving harder.¹ A geriatric psychiatrist is used to sorting out how heart disease, pain, sleep, memory loss and many medicines all affect mood. See medicines that can affect mood and memory.

When it may help to ask for a geriatric psychiatrist:

Depression or anxiety that has not improved after trying one or two treatments. See when depression doesn't get better.
New mental health symptoms that start after age 60, such as hallucinations, strong suspicion of others, or mania
Agitation, sleep problems or personality changes in a person living with dementia. See which specialist to see.
Worry that memory problems may be depression, or depression may be early dementia. See depression in later life.
Taking many medicines, with concern that some are making mood or thinking worse
A long-term illness such as bipolar disorder in later life that is harder to manage with age

The shortage. The number of older Americans is growing fast. There are only about 7,029 certified geriatricians (doctors for older adults) in the U.S., roughly half the number needed. The shortage of geriatric psychiatrists is just as serious.¹ In many areas, especially rural ones, there may be none nearby. That is one reason the options below matter.

Start with primary care: collaborative care

The National Institute of Mental Health suggests starting with your primary care provider. They can refer you to a psychologist, psychiatrist or clinical social worker.² Some primary care offices go further and offer collaborative care in the same office.

In collaborative care, you keep seeing your primary care provider. A behavioral health care manager and a psychiatric consultant join your care team.⁶ The team keeps a record of your goals and how you are doing. If you are not getting better as expected, the team changes the plan.⁶ Services may include care planning, regular check-ins, medicine support and counseling.⁵

What the research shows. The IMPACT study tested this approach in 1,801 older adults with depression, at 18 primary care clinics in five states.⁶ After one year:

After 12 months	Collaborative care	Usual care
Depression cut by half or more	nearly half of people	about 1 in 5 (19%)

Over two years, people in collaborative care also had more than 100 extra days free of depression.⁶ In daily life, that is about three more months of feeling well. Strong evidence

Medicare coverage. Medicare Part B may pay for collaborative care and similar "behavioral health integration" services. You must have a condition such as depression or anxiety. The services are billed monthly, and your provider will ask you to sign an agreement first. After the Part B deductible, you usually pay 20% of the approved amount.⁵

Ask your doctor's office: "Do you offer collaborative care or behavioral health integration?" If they do not, ask for a referral to a psychiatrist, psychologist or therapist who takes Medicare.

Steps to find specialist care

Talk with your primary care provider. Describe what has changed and for how long. Bring a list of every medicine and supplement.
Ask for a referral by name. Ask whether they know a geriatric psychiatrist, a geriatric or memory clinic, or a psychiatrist who sees many older patients.
Call your insurance. If you have a Medicare Advantage plan, ask for a list of in-network psychiatrists and therapists, and whether you need approval first.
Ask about telehealth. As of October 2026, Medicare covers therapy and depression screening by video from your home, and in some cases by phone. The current rules run through December 31, 2027.⁷ A video visit can connect you to a specialist far away.
Get on more than one waiting list. Ask to be called if an earlier slot opens. Keep seeing your regular doctor while you wait.
If you are a veteran, contact your VA health care team. See the Veterans section below.

If a family member is helping, see supporting someone in treatment for tips on privacy rules and going to visits together.

Community mental health services

Every state has public mental health services in the community. Their names and rules differ from state to state.

In Virginia, the local public mental health agencies are called Community Services Boards (CSBs). There are 40 of them. Since July 2024, every CSB has offered these core services:⁸

Same-day access: a first screening and safety check on the same day you contact them
Outpatient care: therapy for mental health and substance use, plus psychiatry
Crisis services
Peer and family support from trained people with lived experience
Services for veterans, service members and their families
Case management and care coordination to link you with other resources

To find your CSB, use the "Find your CSB" link on the Virginia DBHDS crisis services page. You can also call 988, and the crisis worker can connect you to local services.⁹

Outside Virginia, call the SAMHSA National Helpline at 1-800-662-4357 (1-800-662-HELP). It is free, private and open 24 hours a day, in English and Spanish. It can refer you to local treatment.¹²

Area Agencies on Aging

Area Agencies on Aging (AAAs) are local agencies that plan and arrange services for older adults in a city, county or region. Their names vary from place to place.¹⁰ They help older adults stay in their homes with services such as home-delivered meals and help with housework.¹⁰

AAAs usually do not provide psychiatric treatment. But they can ease problems that feed depression and stress, such as isolation, poor nutrition and caregiver strain. They can also point you to local senior centers, caregiver programs and other services. See loneliness in later life and caregiver burnout.

How to find yours: The Eldercare Locator is a national public service run by the U.S. Administration for Community Living. Call or text 1-800-677-1116, or chat online at eldercare.acl.gov.¹¹

In Virginia, there are 25 local AAAs. They are the main doorway to home and community services for older Virginians and their caregivers.¹³ The Virginia Division for Aging website has a map to find yours.

Care for older veterans

VA offers special geriatric services for veterans and families coping with complex medical, memory and mental health problems in later life. Veterans having trouble adjusting to retirement or aging can also get counseling.⁴ Ask your VA primary care team about mental health care, or see PTSD in older adults and veterans and VA benefits for dementia.

Questions to ask when you call

Questions about the provider

Do you see many older adults? Do you have training in geriatric care?
Do you take Medicare, and do you accept assignment? Are you in my plan's network?
How long is the wait for a first visit? Is there a cancellation list?
Do you offer video or phone visits?

Questions about the visit

Can a family member come to the visit, or join by phone?
Should I bring my medicine bottles, past test results or a list of symptoms?
Will you talk with my primary care doctor?
Can I get a medical interpreter if English is not my first language? Is there a fee?

When to get help right away

Call 911 if someone is in immediate danger, has hurt themselves, or has a medical emergency.²

Call or text 988 to reach the 988 Suicide & Crisis Lifeline any time, day or night. You can also call if you are worried about someone else.² In Virginia, 988 is also the way into the state's crisis system. Mobile crisis teams can come to where the person is, at any hour. Crisis receiving centers take walk-ins and can provide care for up to 23 hours.⁹

Veterans can call 988 and press 1, or text 838255.⁴

Do not wait for a specialist appointment if someone talks about wanting to die, stops eating or drinking, or becomes confused very suddenly. Sudden confusion can be a sign of delirium, a medical emergency. See when a family member is in a mental health crisis and make a safety plan.

Getting care can take a few calls and some patience. Help works at any age, and you do not have to sort it out alone. For more support, visit older adults or get help.

Sources

American Association for Geriatric Psychiatry. What is geriatric psychiatry? AAGP, 2026. aagponline.org
National Institute of Mental Health. Older adults and mental health. NIMH, 2026. NIMH
Medicare.gov. Mental health care (outpatient). Centers for Medicare & Medicaid Services, 2026. Medicare.gov
U.S. Department of Veterans Affairs. Older veterans: mental health. VA, 2026. VA
Medicare.gov. Behavioral health integration services. Centers for Medicare & Medicaid Services, 2026. Medicare.gov
AIMS Center, University of Washington. IMPACT: Improving Mood, Promoting Access to Collaborative Treatment. University of Washington, 2026. aims.uw.edu
Medicare.gov. Telehealth. Centers for Medicare & Medicaid Services, 2026. Medicare.gov
Virginia Department of Behavioral Health and Developmental Services. STEP-VA. DBHDS, 2026. dbhds.virginia.gov
Virginia Department of Behavioral Health and Developmental Services. Crisis services. DBHDS, 2026. dbhds.virginia.gov
Administration for Community Living. Area agencies on aging. U.S. Department of Health and Human Services, 2026. ACL
Administration for Community Living. Eldercare Locator. U.S. Department of Health and Human Services, 2026. eldercare.acl.gov
Substance Abuse and Mental Health Services Administration. SAMHSA's National Helpline. SAMHSA, 2026. SAMHSA
Virginia Department for Aging and Rehabilitative Services. Division for Aging. Commonwealth of Virginia, 2026. vda.virginia.gov

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.