According to the National Council on Aging (NCOA), approximately one in four older adult Americans have a mental health disorder. This population is expected to double to 15 million by 2030. Due to the influx of behavioral health issues in the older population, the Substance Abuse and Mental Health Services Administration (SAMHSA) & the Administration on Aging (AoA) put out a brief report detailing the state of mental health within this older population. Currently:
- Depression affects approximately 3-7% of older adults
- Anxiety disorders affect 11% of the general older adult population.
- In 2007, the rate of suicide among older adults was approximately 14.3 per 100,000 with older men having the highest suicide rates of any age group among the general population.
In additional to the increasing rate of behavioral health among the older adult population, substance abuse rates for this very population are also on the rise. According to SAMHSA and NCOA, one in five older adults may be affected by combined difficulties with alcohol and medication misuse.
Physical Conditions & Behavioral Health
The U.S. Department of Health and Human Services (HHS) recently discussed the many physical health conditions that may accompany a behavioral health diagnosis in the older adult population. Many of these physical health conditions prove to be very acute and limit the mobility of those who suffer from them. Clinically significant depression in late life has been shown to run concurrently with physical health conditions such as ischemic heart disease, diabetes, stroke, cancer, chronic lung disease, arthritis, Alzheimer’s disease, and Parkinson’s disease.
Evidence-Based Practice for Treating Depression
Depression is not a normal part of growing older, and treatment works. Three effective evidence-based practice models for treating depression in the older adult populations are the IMPACT, PEARLS, and Senior Reach models.
- IMPACT (Improving Mood-Promoting Access to Collaborative Treatment) implemented a two-step process of care for patients consisting of a systematic diagnosis and outcomes tracking measure (PHQ-9 initial intake) followed up by stepped care which adjusted treatment based on clinical outcomes. Results show that the IMPACT model of depression care more than doubled the effectiveness of depression treatment specifically in the elder population.
- PEARLS (Program to Encourage Active Rewarding Lives for Seniors) implemented a six to eight in-home session treatment model that focuses on brief behavioral techniques, allowing the in-home counselor to empower each individual. Results show that PEARLS participants are more likely to have a significant reduction in depression and the program is helpful in effectively screening for and treating frail older adults through community-based organizations that used non-pharmacological methods.
- Senior Reach Training is provided to members of the community to identify, offer outreach services to, and refer at-risk independent-living older adults. These community partners serve as nontraditional (e.g., restaurant and retail staff, bus drivers, senior center staff) and traditional (e.g., primary care physicians, adult protective services) referral sources. Results show that Senior Reach participants had a decrease in depression and improvement in dimensions of social, physical , and mental health functioning.