Population ageing is currently viewed as most wide-spread demographic trend. Decreasing fertility and increasing life expectancy have tremendously altered the ratio between the young and old in current population of the world. Global UN research on population ageing (2007) suggests that population ageing is concerned with four salient aspects, such as being unprecedented in human history; pervasiveness of the trend, which is now affecting almost all parts of the world; enduring nature of the trend (the situation is not likely to be subjected to significant changes; and, what is more important, the trend’s having profound consequences for almost all aspects of societal life. One of these trends deals with population aging calling forth the need for reconsideration of healthcare policies, so that they are more capable of meeting not only physical health-related, but also emotional health needs of older adults.
Background and the issue
I have become interested in the way to introduce a healthcare policy, aiming at meeting emotional health needs of older seniors after I have got aware about an extremely strong link, which exists between age and the state of mental health. . According to CDC (2008) study on aging and mental health, it is estimated that 20% of people, aged 55 or older, experience particular type of mental health concern (p.2). Most wide-spread conditions are anxiety, severe cognitive impairment and disorders in mood such as depression and bipolar disorder (p.2) Furthermore, lots of older Americans tend to state that they have never received adequate social and moral support they needed (CDC, 2008, p.3). Specific attention in this regard is to be paid to treating depression in the elderly due to the current trend of underestimating depression in older population (Ruppel et al., 2010, p. 38) and overall level of depression prevalence in the elderly of 11.19 per cent (Steffens et al, 2009, p.884). Very often the elderly are not able to correctly identify the symptoms of depression and mistake them just for “being old”. The authors suggest that one of the reasons of missing depression symptoms by physicians was the “co-morbidity of other physical health issues” (Ruppel et al., 2010, p. 138).
Current state of the issue
Despite the fact that mental parity legislation was introduced to the U.S. legal system in 2008, providing equal coverage for physical and mental health conditions, the stigma did not get away, therefore, may elderly are still reluctant to acknowledge the fact that they suffer from any kind of treatable disorder, such as depression or anxiety.
Changes to be implemented in order to promote mental health parity
My first recommendation with regard to promoting the parity of mental health disorders in relation to geriatric medicine, lies in launching a public campaign, aiming at explaining the notion of parity between physical and mental health to the target group, namely, the elderly, who receive formal care.
Raising awareness campaign may be conducted win relation with spreading self-evaluating tools, which will allow the willing participants to get to know their mental condition from outside and get the consultation of a specialist afterwards.
Thirdly, special attention should be dedicated to raising awareness about mental health issues and parity among people, who provide their elderly parents and relatives with informal care, which is most often viewed as effective substitute for long-term care in case the needs of the elderly do not require skilled help. This campaign should help care givers get to know that they should care not only about meeting physical health-related needs of care receivers, but their emotional state.
Another direction of the multitarget campaign under study is to be aimed at raising nurses’ awareness about emotional health issues. This need is called forth by the fact that particularly nurses represents vast majority of personnel in residential care settings, and curricula, used to prepare nurses for their future occupation, do not tend to concentrate on getting an in-depth insight into emotional health issues. Therefore, a threat may exist that exactly as informal caregivers, nurses can be at some point unable to identify the need to pay more significant attention to the state of patient’s emotional health. Special courses on geriatric psychiatry are to be designed for nurses, who are involved in providing services for older citizens in residential care settings. This direction can be broadened with respect to doctors, who may be in need of getting extra knowledge in the area under study. Specific attention should be paid to highlighting the relationship between geriatric issues and mental health.
Questions on the way the change might occur
- Do you consider the change going in line with current priorities of the U.S. healthcare policy development?
- Should the issue be resolved with the help of federal or state policy-making tools?
- Which best practices of foreign countries or the European Union can be used in order to promote physical and mental health parity in the elderly?
- How can non-governmental organizations become involved in implementation of the policy under study
The issue of wide spread mental health disorders among the elderly should be specifically targeted in terms of the U.S. health care policy-making due to the fact of seriousness of the issue being underestimated for quite a long time. Combating mental health disorders-related stigma requires complex raising awareness action, encompassing potential mental and emotional health care receivers; persons, providing target group with informal services, as well as healthcare professionals, involved in provision of the residential care for the elderly. Future issues to be resolved with regard to elaborating on the policy concern its aligning with existing priorities of the U.S. healthcare policy, studying related world best practices, and identifying the level of policy implementation.
CDC (2008). The state of mental health and aging in America. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services
Robinson, K.M. (2010). Policy issues in mental health among the elderly. Retrieved 4 January 2013 from http://www.nursingconsult.com/nursing/journals/0029-6465/full-text/PDF/s0029646510000733.pdf?issn=0029-6465&full_text=pdf&pdfName=s0029646510000733.pdf&spid=23756026&article_id=773371
Ruppel, S. E., Jenkins, W. J., Griffin, J. L., &Kizer, J. B. (2010). Are they depressed or just old? A study of perceptions about the elderly suffering from depression.North American Journal Of Psychology, 12(1), 31-42.
Steffens, D., Fisher, G., Langa, K., Potter, G., &Plassman, B. (2009). Prevalence of depression among older Americans: the Aging, Demographics and Memory Study. International Psychogeriatrics, 21(5), 879-888
UN Department of Economic and Social Affairs. (2007). World population ageing. New York: United Nations