By Liz Seegert | Aug. 4, 2023
Reporting on older adults’ mental health requires a comprehensive understanding of the unique challenges and needs of this population. It’s also important to remember that “older adults” is not a homogenous group, just like any other demographic. Cultural, societal, socioeconomic and other factors all impact older peoples’ relationship with mental health and care.
Aging often involves major life changes, such as learning to cope with a serious condition like heart disease, or losing a loved one. Feelings of grief, social isolation and loneliness can lead to mental health issues like depression or anxiety, according to the National Institute of Mental Health. Although discussing and treating mental health problems has become more normalized, many older people are still reluctant to share their thoughts and feelings, due to generational social stigma about the topic.
Mental health is important at every stage of life. But older adults have unique issues compared to younger adults, Dilip Jeste, M.D., told the National Alliance on Mental Illness in 2013.
“The most common neuropsychiatric disorder in older people is dementia, especially Alzheimer’s disease,” Jeste said. “While major depression is less common, milder forms of depression are far more common than in younger adults.
Jeste went on to say that due to age-related changes in the functioning of the liver, kidneys and brain, “older people can only tolerate lower doses of most medications and are at a greater risk of developing a number of side effects.”
They are also less likely to be living with their families and, therefore, have a special need for psychosocial treatment — on top of having significant physical illnesses and disabilities, visual and/or hearing impairments, and even less access to health care than younger adults, he said.
“As a result, fewer than half of older Americans with mental illness receive the needed mental health services,” Jeste said. “They face the dual stigma of mental illness and aging.”
Signs and symptoms of mental health problems in older adults are frequently dismissed or ignored as routine parts of aging, as The Seattle Times recently reported. Physical symptoms can actually be a sign of mental health issues, according to Daniel Sewell, M.D. But, as The Centre for Addiction and Mental Health in Toronto found, “Primary care providers may not be equipped to identify mental illness or dementia in older patients, or have the capacity to manage complex conditions.”
Here are some points to keep in mind about older people and mental health:
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Symptoms like mood changes, trouble sleeping, difficulty concentrating, stress, anger, sadness, thoughts of death, seeing or hearing things no one else does, or even misuse of alcohol or drugs can all be mistaken or misdiagnosed as “normal” age-related changes, according to the National Institute of Mental Health.
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Depression is the most prevalent mental health problem among older adults. Older adults with depression visit the doctor and emergency room more often, use more medication, incur higher outpatient charges, and stay longer in the hospital, the CDC found. Most depression, once diagnosed, is treatable.
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According to the Substance Abuse and Mental Health Administration, age-related cognitive, functional and sensory impairments can interfere with diagnoses of mental health issues in older people. They can also affect an older person’s ability to follow through with treatment regimens.
When reporting on mental health and older adults, here are some tips and resources to keep in mind:
1. Highlight the prevalence: All baby boomers (born 1946-1965) will be 65 or older by 2030, outnumbering the number of children, according to the U.S. Census Bureau. The need for mental health services is only increasing.
According to the World Health Organization, around 15% of adults age 60 and older experience a mental disorder. Approximately 20% percent of Americans 65 and older will experience mental health issues, and up to 4.8% will have a serious mental health issue. These include one or more diagnoses of mental disorders combined with significant impairment in functioning, according to the Substance Abuse and Mental Health Administration. Older adults with a serious mental health issue have substantially higher rates of diabetes, lung disease, cardiovascular disease, and other comorbidities. They also have significantly impaired psychosocial functioning.
2. Discuss risk factors: Common risk factors that can impact mental health in older adults include:
The National Institute on Aging offers valuable insights into these factors.
3. Promote healthy physical and mental health at all ages: Showcase positive aspects of aging and how active engagement in social, physical and cognitive activities can support mental well-being in older adults.
4. Address stigma: Shed light on the stigma surrounding mental health issues in older adults, which may discourage them from seeking help. This may be especially true for older adults from certain cultures or the LGBTQ community.
5. Explore therapeutic interventions: Investigate evidence-based therapies and interventions that have proven effective in treating mental health conditions in older adults. The American Psychological Association offers insights into psychological treatments for seniors.
6. Suicide prevention: Address the issue of suicide among older adults. Adults aged 75 and older have one of the highest suicide rates at 20.3 per 100,000, according to the CDC. Men 75 and older have the highest suicide rate of any age group at 42.2 per 100,000. The Suicide Prevention Resource Center is a good resource for data and resources to aid in suicide prevention reporting.
7. Ensure cultural sensitivity: Be aware of cultural factors that may influence mental health perceptions and help-seeking behaviors in diverse older adult populations. The National Alliance on Mental Illness offers cultural competence resources.
8. Promote geriatric mental health services: Inform your audience about available mental health services tailored to older adults, such as geriatric psychiatry and counseling. The Geriatric Mental Health Foundation can provide valuable assistance about these services.
9. Address long-term care facilities: Investigate the mental health challenges faced by older adults in long-term care facilities and discuss efforts to improve mental health support in these settings. The Alzheimer’s Association provides resources on dementia care. The Long Term Care Community Coalition can discuss challenges to mental health care specific to nursing homes.
10. Look at policy efforts: Explore and highlight policies that can positively impact mental health support and access to care for older adults. The National Council on Aging offers policy resources related to aging and mental health.
Additional resources
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988 Suicide & Crisis Lifeline : The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat.
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Veterans Crisis Line: This helpline is a free, confidential resource for veterans of all ages and circumstances. Dial 988 then press 1, text 838255, or chat online to connect with 24/7 support.
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Disaster Distress Hotline: This helpline from the Substance Abuse and Mental Health Services Administration provides immediate crisis counseling for people experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a day, 7 days a week. Call or text 1-800-985-5990.
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Linking Older Adults with Resources on Medication, Alcohol, and Mental Health (SAMSHA, 2019)
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Barriers to Mental Health Treatment in Rural Areas (Rural Health Information Hub, 2019)
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Telehealth Counseling for Older Adults With Depressive Symptoms (National Institute on Minority Health and Health Disparities, 2022)
