How to Support Senior Citizens With Depression
by Lisa DiFalco
The mental health needs of senior citizens are often overlooked within a community. A significant percentage of older adults, specifically, one in four, have a mental health disorder, as reported by the National Council on Aging. This population of older adults with mental health disorders is predicted to double to 15 million in 2030, only 14 years from now. More needs to be done to assist older adults in receiving mental health services for conditions such as depression and anxiety. Understand how families, community leaders and mental health professionals can address this growing mental health issue affecting senior citizens.
What Is the Extent of Mental Health Disorders in Older Adults?
Older adults are not immune to having or developing a mental health disorder. However, they are less likely to have family or friends around to notice the condition and help them seek appropriate treatment. The Administration on Aging (AoA) and the Substance Abuse and Mental Health Services Administration (SAMHA) provide a brief overview of the current state of mental health in older adults. A few findings help highlight the plight faced by this vulnerable population.
- About 3 to 7 percent of older adults exhibit signs of depression.
- 11 percent of the population demonstrate an anxiety disorder.
- Suicide is a significant concern for older males in this general population as they have the highest suicide rates within this group. The rate of suicide for older adults was found to be 14.3 for every 100,000 in 2007.
- Substance abuse rates are rising. One in five in this population may experience difficulties from the combination of alcohol with medication misuse.
Health professionals would do well to take note of the signs of depressive behavior in patients. A recent study by the American Geriatrics Society showed that older adults with “high levels of depressive symptoms” were at a greater risk for experiencing stroke or heart disease events. The study ran over 10 years and involved 7,313 older adults. When the study began, none of the participants had a medical history of stroke, heart disease or dementia. Older adults interacted regularly with the researchers, and notes were made as to their depressive symptoms. Researchers formed the conclusion that depression can be considered a risk factor for both stroke and heart disease, because they discovered:
“[A]dults 65-years-old and older who had high levels of depressive symptoms on one, two, three or four occasions during the study had 15 percent, 32 percent, 52 percent, and 75 percent greater risk, respectively, for experiencing heart disease or stroke events over the 10 years of the study.”
Older adults are also, at times, handling acute and physically limiting conditions. Significant levels of depression also appear to co-occur with physical health conditions, including diabetes, stroke, cancer, ischemic heart disease, chronic lung disease, Parkinson’s disease, Alzheimer’s disease and arthritis. Depression does not have to take hold within this population, and effective treatments are available for older adult populations.
How Can Behavioral Health and Mental Health Professionals Best Serve Older Adults?
Older adults need support in moving through and overcoming depressive symptoms. Depression is not only a mental health issue, but it also can impact older adults’ physical health, placing them at higher risk of heart disease and stroke. Behavior health analysts, case managers and mental health professionals should look into the three evidence-based models of treatment for older adults who are experiencing depression:
- IMPACT (Improving Mood-Promoting Access to Collaborative Treatment) offers a two-step process of care that includes systematic diagnosis and an outcomes-tracking measure followed with stepped care based upon clinical outcomes. This model was found to more than double the efficacy of depression treatment in the target population.
- PEARLS (Program to Encourage Active Rewarding Lives for Seniors) is an in-home session treatment model that allows in-home counselors to empower seniors using brief behavioral techniques. Results have shown significant reduction in depression in participants and happens to also be helpful in screening and treating frail older adults with non-pharmacological methods delivered within community-based organizations.
- Senior Reach training helps community members identify, refer and offer outreach services to independent older adults who are at risk of a mental health condition. Nontraditional and traditional referral sources widen the ability to identify and serve those at risk. Senior Reach participants showed improvements in physical, social and mental health functions and a decrease in depressive behaviors.
These are three evidence-based programs that work with the community to improve mental health outcomes for older adults with depression as well as to identify frail older adults. Extending referral sources to nontraditional participants, such as restaurant and retail staff, senior center staff and bus drivers, helps widen the net within the community to identify and better serve older adults, since many lack the social supports to be aware of any changes within an individual or get them the mental health support they may require. Community members, behavior health professionals, physicians and nurses can help independent-living seniors receive specialized treatment for depression that will not only help reduce depressive symptoms but place them at lower risk of stroke and heart disease. There are ways to better serve older adult populations with depression and to identify those at risk. Evidence-based programs offer proven methods that have already helped the target population suffering from depressive symptoms to combat their mental health condition.