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Understanding Mental Illness in Our Elderly

We all know that as we get older our bodies tend to give way to the ravages of time: sports related injuries creep up quickly and become disabilities, genetic predispositions can attack us mercilessly (i.e., heart disease for one) and a life-time of bodily misuse and abuse by each of us (lack of exercise, poor diets, etc.) shows how important those activities are for a healthy and prolonged life. Yet, with all the emphasis on physical health, little focus seems to be given to our mental health status, other than the drive to understand and treat various diseases like Alzheimer’s disease. Mental illness in our elderly population is under-diagnosed, mistreated and often couched in the perpetual myths and misperceptions that often plague our elderly.

In the article, Overlooked and Underserved: Elders in Need of Mental Health Care, written by Trudy Persky, MSW, ACSW, Project Director for Mental Health and Aging in the Philadelphia area; several very telling statistics are cited.

Elders account for only 7 percent of all inpatient psychiatric services, 6 percent of community mental health services, and 9 percent of private psychiatric treatment care. Less than 3 percent of all Medicare reimbursement is for psychiatric treatment of older patients. It is estimated that 18 to 25 percent of elders are in need of mental health care for depression, anxiety, psychosomatic disorders, adjustment to aging, and schizophrenia. Yet, few seem to receive proper care and treatment for these mental illnesses. It is also a distressing reality that the suicide rate of the elderly stands at an alarming 21 percent, the highest of all age groups in the United States. Every day 17 older individuals kill themselves.

Clearly, we have an elderly population that needs help for their mental illness issues, and, as our elder population continues to grow (some estimates project the elder population to double to 70 million by 2030) the need for such intervention will continue to expand. However, such intervention may be thwarted by the lack of qualified and skilled practitioners.

“By then (2030), there will only be 2,000 additional trained geropsychiatrists to meet the need, yet many of the country’s current 2,500 geropsychiatrists will be ‘off the scene’ by then,” according to this Unmasking Mental Illness in the Elderly article featuring Geropsychiatrist Shreekumar Vinaker, M.D.

Couple the projected shortage of geropsychiatrists with the fact that “the incidence of Alzheimer’s disease doubles for every 5 years of age after 60, so by the time someone reaches 85, his or her chance of developing this dreaded, irreversible condition is 50-50” and we have a serious lack of adequate resources to treat our elders for mental illness.

Potential treatment of mental illness for our elder population is further complicated by several factors, including:

  1. The elder population tends to not seek out medical care.
  2. As we age, physical illness and mental health illness become inextricably intertwined, making it difficult for general medical practitioners to diagnosis certain illnesses.
  3. Families of the elders often form certain denial habits.
  4. Service providers and their networks are often hard to locate and even more difficult to access.
  5. The stigma of getting labeled with mental health issues can be a deterrent to entering the service provision arena.

With these and several other factors, our elderly population is severely underserved from a mental health perspective. Your role, as a senior care activist, is to continually advocate for regular physical and mental health check-ups for your clients (and your family members) in order to diagnosis any illness and find appropriate treatment as early as possible.

We may not be able to stop the aging process and how it affects us both physically and mentally, but we can understand how that process works. We can help to educate others on the aging process, and we can certainly be advocates for continual reform of our service delivery systems to aid in longer and healthier life experiences for our elders.




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