As older adults with mental illness age, they face limited access to care. Here's why.

Older adults with serious mental illness have more difficulty accessing appropriate residential treatment facilities such as nursing homes, in-patient rehabilitation facilities and hospice care.

It's a problem that will, eventually, affect many of the roughly one-quarter million adults in Wisconsin with a serious mental illness.

Related: Older Wisconsinites have the highest suicide rate of any age group. Why don't we talk about it?

Why is receiving care a problem?

Much of the access issue, according to geriatric medical experts, comes down to a majority of medical providers not having adequate training to care for people with serious mental illness.

According to the 2019 Wisconsin Behavioral Health System Gaps report conducted by the University of Wisconsin Population Health Institute, older adults also experience gaps in treatment due to workforce shortages, stigma and prejudice, geography, and lack of appropriate community services.

An example of this, highlighted by the report, is that people with dementia-related aggression often end up in a state mental health facility. "This is not where they belong, and it is only due to no appropriate crisis intervention alternatives," the report said.

Around 80% of dementia patients, at some point, experience a mental health problem, said Dr. Kenneth Robbins, a geriatric psychiatrist at Agrace Hospice in Madison. The diagnosis itself can lead to depression and suicidal thoughts, and, as the disease progresses, has a high incidence rate of anxiety and psychosis. But if a provider has a good understanding of how to manage mental health symptoms, "people can do very well with dementia," he said.

How bad is the workforce shortage for older adults?

Sarah Endicott, a psychiatrist specializing in geriatrics, said that around 3% of all Wisconsin physicians in psychiatry specialize in geriatrics.

If existing geriatric psychiatrists took on all the older adult patients with serious mental illnesses, each would have around 20,000 patients.

Why is there a workforce shortage?

Geriatric psychiatry, as a profession, doesn't have the allure of other medical professions for a number of reasons, said Robbins, who is also adjunct professor of psychiatry at University of Wisconsin-Madison.

"You have to be comfortable with medicine, and psychiatry, and neurology," Robbins said. Compounding that, Robbins said it's a "pretty Medicare-focused practice," meaning that, from a financial point of view, it's not a well-paying part of psychiatry.

That's unfortunate, Robbins said, because geriatric psychiatry is a rewarding field. There's so much to learn about older adults, their lives and perspectives, and of course, there's also a great need.

How does Wisconsin compare to other states?

Wisconsin is "very far behind a number of other states" when it comes to adequate behavioral health treatment services for the elderly, according to the behavioral health treatment gaps report.

Providers on the whole could benefit from more training to work with the aging population, the report said. It's something Mary Kay Battaglia, executive director of NAMI Wisconsin, said is sorely needed.

Battaglia said the state should take advantage of the "wealth of knowledge" of licensed practitioners who, on the verge of retirement, only work part-time.

Using their talents to train the next generation would be optimal, but neither the state nor organizations in the field want to hire someone at that pay level, Battaglia said.

"I just think we are failing the opportunity for them to mentor younger people and to utilize the skills they've acquired over time," Battaglia said. "They'd be willing to work a couple of days a week but we're not capitalizing on that."

Natalie Eilbert covers mental health issues for USA TODAY NETWORK-Wisconsin. She welcomes story tips and feedback. You can reach her at neilbert@gannett.com or view her Twitter profile at @natalie_eilbert. If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at 988 or text "Hopeline" to the National Crisis Text Line at 741-741.

This article originally appeared on Green Bay Press-Gazette: Most providers aren't able to treat older adults with mental illness