By Linda Johnson, MD

Mental health is a global issue for seniors.  According to the World Health Organization, 15% of adults suffer from a mental disorder with depressions representing 7%, anxiety 3.8% and substance abuse 1% although this is likely too low a number as it is often overlooked or misdiagnosed.  Sadly, 25% of deaths from suicide are people age 60 or above.  According to the Centers for Disease Control and Prevention (CDC) in the United States 20% of people age 55 and older experience some type of mental health concern with the current rate of depression being as high as 19.3%.  In the United States, older men have the highest suicide rate of any age group.  Men age 85 years and older have a suicide rate 4 times higher than the overall population rate.

So why is this such an issue.  Seniors experience several stressors including declining health, significant ongoing loss of capacities, reduced mobility, chronic pain, frailty or health problems.  Seniors are more likely to experience events like bereavement as spouses, other family members and friends pass away.  They often deal with a drop in socioeconomic status with retirement, isolation, loneliness, and psychological distress.

Mental health has an impact on physical health and vice versa.  For example, older adults with conditions such as heart disease have higher rates of depression.  Untreated depression in an older adult with heart disease can negatively affect its outcome- more symptoms and not live as long.

Older adults are also vulnerable to elder abuse with current evidence suggesting that 1 in 6 older people experience some form of elder abuse.  This can be physical, verbal, psychological, financial, sexual, abandonment, or neglect.

So, what can the health profession and the community do to combat this?  All seniors should be regularly screened for risk factors and signs of depression.  We need to raise awareness about mental health issues and the effectiveness of treatment, remove the stigma, eliminate health disparities, and improve access to mental health services.  On surveys, seniors have too high a rate regarding lack of social support and decreased life satisfaction.

What can a senior do for themselves and their family or friends in dealing with this issue?  There is a great deal that they can do.  It all centers around keeping the mind active and engaged.  It starts with keeping moving.  Exercise helps both mental and physical health.  It is even better if that exercise is coupled with social interaction.  Going to a gym with other seniors, taking a dance class at the senior center, joining a walking group or any variety of social exercise activities.

In addition to exercise, socializing in general has great benefit.  Joining a bridge club or other form of cards or games, joining a gardening club/class, etc.  Go back to school!  Many local colleges offer classes for seniors for free.  I had a patient who was a retired engineer who took an art history class and ended up writing a book about the history of art in the casinos in Las Vegas.  It surprised himself as much as anyone.  Turn to technology to stay in touch with family and friends- Skyping and facetime.  Get a pet if you are able- they provide love and exercise.  Make a deeper spiritual connection by getting involved with your local church of choice.   Finally, volunteering in the community is a way to stay active in many ways – it is a win for the senior and the charity or organization.

If we work together, we can make an impact on mental health and seniors.  We can remove the stigma, provide effective treatment and reduce social isolation and loneliness.