One good thing: On Jan. 1, Medicare will gradually begin reimbursing for mental health treatment the same way it reimburses for care of cancer or kidney disease.

The current policy, as old as Medicare itself, treats mental illness differently from physical illness, a discrepancy that discourages elderly patients from seeking help for psychiatric problems.

Medicare generally pays participating physicians 80 percent of its allowed charge per visit or procedure, with the beneficiary responsible for the remaining 20 percent. The exception? If that participating professional is a psychiatrist, psychologist or psychotherapist, Medicare reimburses only 50 percent; the patient gets the bill for the other half.

The lobbying for mental health parity in Medicare began years ago but intensified after the 2006 elections. “A Democratic majority is a better atmosphere for passing mental health legislation,” said Stephanie Reed, associate director of government affairs for the American Association for Geriatric Psychiatry.

A phalanx of professional organizations and mental health advocacy groups argued that Medicare’s policy was, in Ms. Reed’s words, “tremendously discriminatory” and helped perpetuate the stigma of mental illness. Both Democrats and Republicans supported the Medicare Improvements for Patients and Providers Act, which passed into law over President George W. Bush’s veto and takes effect next year.

Though not all at once. Budget worries led to a phased-in plan over five years. In 2010 and 2011, Medicare will reimburse for just 55 percent of psychiatric services. Not until 2014 will reimbursement reach the standard 80 percent — a long wait for an 85-year-old with, say, depression. But let’s take our victories where we can. One in four older adults suffers a significant mental disorder, according to Stephen J. Bartels, director of the Dartmouth Centers for Health and Aging. This will help.