Mental health crisis among aging

Experts tell Congress rates of illness and suicide are high in U.S.

September 15, 2006|By Moises Mendoza | Moises Mendoza,LOS ANGELES TIMES

WASHINGTON -- Senior citizens have high rates of mental illness and the highest U.S. suicide rate compared with other age groups, a panel of mental health experts told a congressional committee yesterday.

Appearing before the Senate Special Committee on Aging, the panelists said poor access to mental health care, inadequate training of primary care physicians and apathy among seniors contribute to a growing mental health crisis among those over 65.

Seniors account for a fifth of all suicides - many by firearms - and nearly 40 percent show signs of depression, but only 3 percent seek psychological help, the experts testified.

"I think you could probably characterize the situation as a national embarrassment," said psychologist David Shern, president and chief executive officer of the National Mental Health Association, an advocacy group in Alexandria, Va.

Fewer than half of all adults with symptoms of depression are screened accurately by their primary care physicians, he said, urging changes in clinical and training practices.

He also called for more research funding to study suicide risks among the elderly - a view that all the panelists endorsed.

Dr. David C. Steffens, a geriatric psychiatrist at Duke University Medical Center, said that when money gets tight, some seniors choose to stop taking anti-depressants rather than give up medications to treat physical ailments.

But, he said, several projects looking into innovative approaches to seniors' mental health care show promise.

In one study conducted in New York, Philadelphia and Pittsburgh, depression care managers - usually nurses or social workers - worked with physicians to identify patients who showed signs of depression and follow up on their care. Participants in this program showed lower suicide ideation rates than people in a control group, Steffens said.

In another study covering five states, clinical specialists in depression worked with patients in a primary care clinic, reducing their depressive symptoms by up to half when compared with patients who did not receive specialist care, Steffens said.

As the hearing ended, Sen. Gordon Smith, a New Hampshire Republican who is the committee chairman, said:

"There really should be no higher issue for us in Congress than to fix this."

Moises Mendoza writes for the Los Angeles Times.

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