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Older Americans’ Mental Health Week Mental Health and Older Adults: Myths and Realities The following was provided by the Older Adult Consumer Mental Health Alliance There are several myths concerning older adults and mental health. In order to improve access to appropriate mental health care for older adults these must be addressed.

MYTH 1: Older adults are like everyone else. They don’t need specialized services.
The nation’s mental health system is geared toward people who recognize they have a problem, seek out help, and hope to recover for work, family, etc. Many older adults don’t fit into those categories. They don’t seek help because they don’t always know what is wrong except that they feel bad. Instead of going to a mental health center for help, they trust their primary doctor, many of whom are not confident about dealing with mental illness or many just don’t seek help. Some may lack transportation to centers.

Older adults need people that understand older adults’ specific psychological needs, complex physical problems and service supports. Older adults are more likely to have more than one problem. Unfortunately, people over 60 often know very little of about mental health services available and where to access them. And most mental health workers have no idea how to reach out to older adults.

MYTH 2: Older adults’ doctors take care of them; their needs aren’t overlooked.
While 1 in 5 older adults has a serious mental health problem only 1 in 20 gets help. In older adults, the signs and symptoms of depression, anxiety and other mental illnesses are often entangled with physical problems. As one older adult says, “mental illness in older adults has many masks.” It can look like stomach problems, lack of energy, irritability, the flu, grief, loss of weight, lack of sleep, etc.

Therefore many older people don’t know what is causing them to feel bad. A survey by the National Mental Health Association shows that 68% of adults over 65 know little or nothing about depression, so when they go to their doctor they only discuss physical problems. Doctors miss diagnosing depression 50% of the time. In one study in Chicago 80% of the people who committed suicide had seen their primary care physician within a few weeks before they died.

MYTH 3: Depression is part of aging; older people with depression won’t get better.
This is ageism. People expect older adults to be depressed or disoriented because of their age, their loss of family and friends or their sense of purpose. Doctors often confirm this myth by saying things like .... “I would be depressed too if I were in your shoes.” This just confirms the notion that nothing can be done and those older adults should just accept feeling bad. No wonder older adults have the highest suicide rate of any age group. The truth is that older adults can be helped though counseling and medication and people over 60 have the same rate of recovery as younger people.

MYTH 4: If you have never had a mental health problem before, you are safe.
Late life depression is more common than you might think. Many older adults become vulnerable to depression and other mental illnesses in connection with other physical ailments. Stroke, alcohol abuse, Parkinson’s, cancer, arthritis, diabetes and Alzheimer’s can all cause symptoms of clinical depression. Older adult caregivers are at an even greater risk for depression.

MYTH 5: The effects of mental illness among older adults really aren’t that bad.
Even though few older adults with mental illness are violent, the effects of the illness in people over 60 are just as deadly and costly to society. Older adults commit suicide at the highest rate of any age group. Every day 17 adults over 60 commit suicide. For those who continue to live with mental illness, there are serious consequences. Older adults with mental illness are more likely to have physical problems and will spend 2-3 times more trying to deal with those problems and stay sick longer. People with depression are more likely to have strokes, heart problems and need nursing care early.

MYTH 6: The system is doing all it can to help older adults with mental illness.
There are few mental health programs nationwide that have all the necessary components to serve older adults in their communities. Where these programs do exist they have been overwhelmed with participants. The need for these programs is great. Medicare doesn’t really help and actually discriminates against those with mental health problems. Medicare only pays 50% of the cost of outpatient mental health treatment, but pays 80% for physical health treatment. This adds to the present stigma and results in more expensive inpatient treatment.

IT IS TIME FOR MENTAL HEALTH PARITY IN MEDICARE.