Few health care providers have the training to address depression, anxiety, and other conditions in their older patients.
By now, warnings about the impact of an aging population on the nation’s health care system have become familiar: rising numbers of seniors with diabetes, heart disease, and other chronic illnesses; increased costs; and a strained geriatric workforce that is insufficient to meet even today’s needs. But despite well-publicized alarm over Alzheimer’s disease, whose victims are expected to triple by 2050,1 scant attention has been paid to non-dementia-related mental illnesses such as depression and anxiety.
Perhaps that’s because the problem is hiding in plain sight. Many physicians aren’t trained to recognize mental illness in the elderly, patients are often reluctant to discuss their emotional difficulties, and some even blame themselves for not being happier, according to advocates for the mentally ill and physicians trained in geriatric psychiatry. Also, clinicians and, indeed, the patients themselves often miss mental disorders that may exist alongside and complicate physical illnesses that seem to stand out in bolder relief.
But in a 2012 report the Institute of Medicine (IOM) estimated that 5.6–8.0 million senior citizens had one or more mental or substance abuse conditions, with the number predicted to increase to 10.1–14.4 million by 2030.2 The IOM noted that the nation already didn’t have nearly enough professionals with the necessary training to diagnose and treat seniors with mental illness. Without a concerted effort to train more, the shortfall will grow sharply worse in years to come. The report called for the training of not only geriatric specialists but also direct care workers and peer support providers who can screen patients and provide brief interventions.
– Health Affairs