Mental Health Needs and Older Adults
Darolyn Hilts, Ph.D.
Mental health treatment needs are often overlooked in older persons. There are many myths regarding older person’s needs and their ability to benefit from treatment. Consider the following facts:
• It is estimated that between 18% and 25% of older persons will at some time need treatment for mood disorders, adjustment problems, or serious mental illness. Nevertheless, studies suggest that up to 63% of older adults do not receive the services they need.
• Among the most common of emotional problems noted in older adults is depression.
• Depression is often overlooked in older persons, sometimes because it coincides with medical illness or life events, such as loss of loved ones. Nevertheless, depression is NOT a normal part of aging. Depression is also likely to lead to greater impairments in physical, cognitive, and social functioning in older persons than in younger persons who are depressed.
• Risk factors for depression in older persons include previous bouts with mood disorders, widowhood, impaired physical functioning, and heavy consumption of alcohol or other substances.
• Some older persons have a long history of struggles with substance abuse or a serious mental illness. It is important to remember that their need for monitoring and treatment does not diminish just because they are older. Research shows that most older people do desire treatment for their mental health concerns. Unfortunately, they do face some barriers to accessing services such as:
• Older persons often attribute symptoms of emotional difficulties such as sleep disturbances, changes in appetite, and mood differences to physical problems. As a consequence, they may be more likely to identify their problems to medical professionals as a physical complaint than a “mental health concern”.
• Primary care providers are sometimes not adequately trained to assess behavioral and emotional problems. Time pressures resulting from insurance guidelines also make it difficult for medical providers to adequately assess and diagnose emotional and mental health needs in patients.
• Sometimes there is an assumption that a person is “too old” to benefit from mental health treatment. In fact, research shows that older persons are just as likely to benefit from treatment as younger persons.
• Higher co-payments for mental health services than for physical health services are likely to discourage older persons with fixed incomes from seeking mental health treatment. Nevertheless, many providers of mental health services will offer sliding scale fees for older persons of limited income.
A variety of psychological interventions are available that have shown effectiveness in helping older persons. These include therapies with cognitive-behavioral, interpersonal, problemsolving, psychodynamic, and reminiscence approaches. In some cases, medication may also be a useful and necessary component of comprehensive treatment.
Remember, whether you are concerned about yourself or a family member, a person is never too old to address emotional difficulties in life. There is effective help available. Resources for accessing such care include this website, community senior centers, social service and mental health organizations, and medical professionals.
Darolyn Hilts is a Licensed Psychologist in private practice in Wilmington.
For more information on mental health issues for older adults:
National Mental Health Association
National Institute of Mental Health (NIMH)
Alliance for Aging Research