Abstract
The provision of mental health care to older Americans poses a unique set of challenges to service providers. Barriers to the provision of care exist at both system and individual levels. Changes in political ideology from the Reagan through the Clinton administrations brought spending cuts and increasing uncertainty about the future of social welfare programs. Faced with frequent funding changes at the federal level, state and local governments must plan services in a framework of uncertainty. This uncertain political atmosphere puts the provision of mental health care to older persons in jeopardy. Medicare reimbursement rates for mental health care are low—about one half the usual and
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