Ohio currently has 2.86 million people aged 60 or older, representing 24% of the state's total population, making Ohio the sixth-largest older adult population in the country. As more Ohioans continue to age, the more this population is expected to grow. By 2030, the state's older adult population is estimated to increase by 33%; 1 in 4 Ohioans will be aged 60 or older.
Older adults are expected to live longer than previous generations. While the increase in longevity of life is significant, this also means that older adults are also more likely to live with multiple chronic health conditions that will require additional physical care and supportive services.
Is Ohio equipped to meet the behavioral health needs of an aging population?
So how do we promote healthy aging and adequate care for older adults beyond physical well-being? We need to place similar priority on their behavioral health: substance use disorder, mental health conditions, and the social, psychological, and emotional factors that influences a person's overall well-being.
Despite its importance and prevalence, behavioral health is often an afterthought in conversations about aging. Often the primary focus is centered on preventing and treating chronic diseases, long-term care, and access to safety net programs. While all the aforementioned are critical, and deserve discussion, so too does the growing number of behavioral health challenges that older adults are facing, such as chronic loneliness, depression, substance use, and even suicide.
A critical question emerges for our state: is Ohio’s behavioral health system prepared to meet the needs of this growing population? This question is particularly important because Ohio’s behavioral health system currently experiences challenges relating to workforce shortages and access to care that can leave Ohioans without adequate support for their behavioral health needs.
As of 2025, 75 of Ohio's 88 counties (85 percent) were identified to be mental health professional shortage areas.
There are an estimated 2.4 million Ohioans in need of support from behavioral health professionals. As of 2025, 75 of Ohio's 88 counties (85 percent) were identified to be mental health professional shortage areas. This is a 10 percent increase from 2021. That year, 65 of Ohio’s 88 counties (75 percent) were identified as mental health shortage areas. Between 2013 to 2019, there has been a 353 percent increase in need for behavioral health treatment for vulnerable populations. The workforce only increased 174 percent during that same time period.
Worrying behavioral health trends among older adults
There are worrying trends regarding the behavioral health of older Ohioans, especially concerning poverty. With regard to poverty, the most substantial differences in mental illness amongst older adults emerge above and below the federal poverty level (FPL). The Brookings Institution reports that older adults below the FPL are 164% more likely to have depressive symptoms, and 74% more likely to have alcohol use disorder (AUD). In addition to this, older adults with serious mental illness (SMI) with earnings above the poverty level are 1.6 times likely to receive treatment compared to those below the FPL.
Substance use among older adults has been increasing as well. Among older adults, alcohol remains the most prevalent substance used by older adults. Rates of alcohol use disorder increased by 107 percent between 2001 and 2013. In 2022, one in 11 individuals above the age of 60 had a substance use disorder.
Suicide is another significant trend amongst adults. It is the eleventh leading cause of death in the United States, and the eighth leading cause of death for people between the ages of 55-64 in 2023. People between the ages of 80-84 had some of the highest recorded suicide rates in 2024, with 21.7 per 100,000. Individuals over the age of 85 had the second largest rates of suicide, with 21.4 per 100,000. That same year, the CDC reports that Ohio had 1,856 deaths from suicide.
Broadly, Ohio ranks 40th out of 50 states in life expectancy (75.6) and ranks sixth in the nation for its older adult population (2.8 million). By 2034, the number of Ohioans over the age of 65 will drastically increase higher than any other demographic population in the state. This change over time will have significant impact on older adults facing poverty challenges.
What is Ohio doing to support older adults?
Ohio's current state aging plan has several initiatives that work to improve the betterment of older adults and their behavioral health needs. Improving mental health is a key objective under population health in the aging plan. More specifically, Objective 17.1, “Mental Health: Reduce Depression,” seeks to decrease the percentage of adults 65 and older who had reported poor mental health for 14 or more days in the past 30 days from 7.7 percent in 2018 to 6.8 percent in 2029.
Area Agencies on Aging (AAA) are coordinators of services that connect older adults to services to improve behavioral health needs, and thus, are central to Ohio's broader plan to support the behavioral health needs of older adults. AAAs are stipulated to work with the Department of Behavioral Health (DBH) to create awareness of mental health, reduce barriers for treatment and diagnosis, and coordinate behavioral health and mental health services for older Ohioans.
On May 1st, 2026, Governor Mike DeWine announced the launch of the Ohio Aging Compass, a centralized platform which hosts aging resources, tools, and long-term care details. Resources for agencies and service providers are included in the platform, along with a searchable directory of institutions that provide family services. Taken together, the Ohio Aging Compass seeks to provide a centralized location for tools and resources to help Ohioans age well.
75 percent of adults aged 50 and older want to remain in their homes and 73 percent want to remain in their current community for as long as possible.
Home and Community Based Services’ impact on Older Adults
An additional point of consideration for Ohio’s aging population is the future of Home and Community Based Services (HCBS). While often discussed in the context of long-term care and other physical needs, HCBS also plays a key role in supporting behavioral health. For many adults, remaining in their homes and communities is a top priority as they age. A recent survey found that 75 percent of adults aged 50 and older want to remain in their homes and 73 percent want to remain in their current community for as long as possible. Through HCBS older adults can maintain independence while also ensuring they can stay connected to meaningful relationships with their family and friends. HCBS can also help reduce the risk of chronic loneliness and social isolation as well as factors associated with depression, anxiety, and other behavioral health conditions. This further demonstrates how vital HCBS is in supporting not only the physical needs of older adults, but their behavioral health as well.
For this reason, recent actions by the U.S. Department of Justice (DOJ) concerning Olmstead v. L.C. have raised concerns for aging and disability advocates. The 1999 Supreme Court decision established that individuals with disabilities have the right to receive supportive services in the most integrated care setting appropriate to their needs. However, the DOJ's memo argues that federal law does not require states to provide HCBS to the extent that it has historically been interpreted.
Although this is the DOJ's position, it currently does not change Ohio's law nor eliminate existing HCBS programs. However, this signaling from the DOJ could encourage states to weaken or reduce their investment in HCBS. At a time when Ohio's older adult population is growing, and the behavioral health needs are increasing, any reductions made to HCBS could potentially undermine the efforts that support healthy aging.
Currently over seven million Americans are living with dementia and 236,000 Ohioans age 65 are older are living with Alzheimer's Disease.
How should Ohio respond?
Addressing workforce shortages, reducing poverty, expanding access to behavioral health services, and preserving HCBS will be critical in ensuring older Ohioans can age with dignity. These issues are already prevalent now and will only be exacerbated as the need continues to grow. Other points of consideration that sit at the intersectionality of aging and behavioral health are dementia and cognitive decline, and barriers to access of care for older adults in rural communities.
Dementia and cognitive decline is another condition that warrants attention, as currently over seven million Americans are living with dementia and 236,000 Ohioans age 65 are older are living with Alzheimer's Disease. As Ohioans continue to age, this will indelibly present behavioral health challenges.
Lastly, barriers to accessing care for older adults living in rural communities equally raise concern too. Transportation limitations, technological insufficiency, and limited broadband access all make it more difficult for older adults to receive timely healthcare and behavioral health services, particularly at a time where telehealth is becoming more modernized. How Ohio responds will determine whether older adults are able to thrive both physically and mentally in the years to come.