Contribution: We need to address the mental health crisis among older Americans

Early on in the pandemic, it became clear that older patients were at greater risk of suffering the most serious effects of the coronavirus, and much attention was paid to taking steps to protect this population. However, despite the impact of the stressors caused by the pandemic and social isolation, equal attention has not been paid to ensuring that their mental health needs are also met. Because of a variety of barriers that reduce the likelihood of treatment, they are far more likely to have an unmet need for psychiatric treatment.

It is time to talk about how to address the mental health crisis among older Americans and the collective responsibility of the health industry for accessible solutions.

In a recent health research survey of Americans of different demographics, we found that only 4% of baby boomers see a therapist or psychiatrist in a typical year, compared with 16% of Generation X respondents and 20% of Millennials.

A lack of mental health treatment across generations is an ongoing health crisis. There’s an epidemic of boomers going undiagnosed due to conditions like anxiety, depression, PTSD, and more – conditions that can exacerbate heart disease and other ailments that become more common and severe as we age. Treating mental illnesses could prevent complications in such conditions later. In our survey, fewer than 1 in 5 boomers said they had been diagnosed with anxiety or depression, compared with 41% of millennials. Almost half of boomers report having high blood pressure, a condition that is positively linked to anxiety.

Many more have unrecognized neurodivergent disorders that are typically diagnosed in younger patients and that were poorly understood in previous generations. Unrecognized and untreated, such conditions can lead to concurrent conditions and unhealthy coping mechanisms such as substance abuse. Only about 1 in 100 boomers in our survey identified ADHD, compared to 6% of Generation X respondents and 12% of Millennials. Such missed diagnoses can also be responsible for misdiagnosis, including doctors mistaking symptoms of ADHD for dementia, making treatment difficult in many ways.

So what’s stopping boomers from delving into mental health?

A number of factors that contribute to this include the persistent stigma of mental health among aging generations, difficulties in finding accessible insurance – including the lack of doctors who accept Medicare – and general practitioners and other health professionals falling short of anachronistic, hold inaccurate views about mental health separate from physical health.

The good news is that there are some new tools available to help fix this problem.

While most of the discussion about the recent rise of telemedicine has centered on the pandemic’s role in accelerating its adoption by physicians, the rapid expansion of telehealth offerings by psychiatrists is arguably an even more radical and transformative change resulting from the pandemic.

The use of telemedicine options by previously reluctant mental health professionals could help those with limited access to mental health services due to geographic proximity or mobility issues that are particularly prevalent among the elderly. It could also overcome the lingering stigma surrounding mental health, which is of particular concern to the elderly, some of whom, for privacy reasons, may not be willing to go to a therapist or psychiatrist’s office in person and deal with telehealth advice from . feel more comfortable their own home.

This surge in telemedicine options for mental health could be part of a fundamental shift to make mental health more accessible, but it is far from being a panacea. It is vital for general practitioners to gain a better understanding of mental health and its inextricable link with physical health, and to advocate the importance of mental health management – especially among elderly patients with whom they have developed a trusting relationship. As New York Times Personal health columnist Jane Brody wrote in October this year: “The human organism does not recognize doctors’ artificial separation of mental and physical illnesses. Rather, the mind and body are a one-way street … Untreated mental illness can greatly increase the risk of physical illness, and physical disorders can lead to behaviors that worsen mental states. “

Boomers, in particular, trust their GPs to provide advice on their health needs. If these practitioners embrace and de-stigmatize these patients’ mental health, they could be the voice to break a jumble of prejudice and cultural baggage while helping them cope with access issues.

Stigma isn’t the only problem preventing older Americans from undergoing psychiatric treatment. Many struggle to find therapists who accept Medicare. One recently Wall Street Journal Article outlines the problem and explains that low reimbursement rates and additional administrative burdens prevent many psychiatrists from adopting Medicare. At the same time, there have been loopholes in state and local government levels of coverage under the Mental Health Equal Treatment and Addiction Act 2008, as well as the lack of enforcement of its policies and the mental health equality aspects of the Affordable Care Act left many others with inadequate coverage .

While the rise in telemedicine mental health services may help resolve some of these problems by expanding geographic scope, the demand for Medicare-covered mental health care far exceeds the number of doctors accepting Medicare. For those considering entering into a relationship with a psychotherapist, this presents a significant barrier that could prevent mental health treatment. For those who already have a privately insured relationship, it can mean the difference between continuing treatment and deciding to abandon it when switching to Medicare.

Hopefully this failure in providing adequate, accessible coverage will be addressed through future reforms. Until then, it will be up to other health care sectors to fill the void.

Everyone has a role to play in ensuring that the mental health crisis is adequately addressed. Private insurers offering supplementary insurance to seniors must include mental health treatment as a core offering. Digital health networks have a responsibility to help make mental health care accessible to everyone, highlight the importance of mental health – especially for older patients who are less knowledgeable about the subject – and highlight it as an equally important aspect of individual health and wellbeing.

New digital mental health offerings, be it affordable telemedicine options or new digital tools like mental health apps, need to ensure that they are doing whatever it takes to reach the aging population and the GPs they trust, rather than mainly themselves addressed to younger generations. When designing these services, they also need to ensure that they are simple, accessible and accessible to all audiences.

Since we understand the interface between physical and mental health, we cannot afford to ignore the vital role mental health plays in prevention and overall well-being, and we must take collective responsibility for ensuring that everyone is provided with mental health services gets you need.


Jacqueline LovelockJacqueline Lovelock is Managing Director Healthcare at R / GA. R / GA is an innovation consultancy that combines global expertise and diverse skills to enable business transformation, customer experience and marketing transformation in diverse industries such as healthcare, retail, finance and more. R / GA is part of the Interpublic Group of Companies (NYSE: IPG).

Erik OsterErik Oster is Associate Director, Marketing and Communications at R / GA, editor of the R / GA editorial content platform FutureVision and author of the R / GA report “Future of Health Experiences”. Before that he was Senior Editor, Agencies at Adweek.

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