How mental health in older adults can be brushed aside

CMU professor: 'We forget that older adults are still full human beings'

An older man and a dog sit together on a bench at the edge of downtown. Older men who attempt suicide have higher lethality because they plan it out, according to Chris Baeumler, crisis team supervisor for Central Michigan Health.

An older man and a dog sit together on a bench at the edge of downtown. Older men who attempt suicide have higher lethality because they plan it out, according to Chris Baeumler, crisis team supervisor for Central Michigan Health.

Frank Rumpenhorst/picture alliance/dpa/picture alliance via Getty I

MECOSTA COUNTY — When people think of depression, they might think of sadness, listlessness and a lack of motivation. Those are common, but not the only symptoms.

Mental health has started to dominate daily conversation more, but older adults can be left out.

“So you can end up with older adults who are being treated for memory loss, when memory loss is not really the problem," said Dr. Emily Bloesch, an associate professor of psychology at Central Michigan University. “The problem is this underlying mental health problem, like depression, but it’s just harder to recognize.”

Senior mental health is sometimes brushed under the rug, she said.

“We forget that older adults are still full human beings that have their physical bodies, but also just as full and rich mental and psychological lives," she said.

Tending to mental health can be challenging with current data, Bloesch said. There are not a lot of longitudinal studies. Psychologists studying seniors can also run into selection bias. It’s the process where choosing study participants can skew the results — and it can be impossible to avoid. For example, when choosing older study participants, people who survive to 65 are then more likely to make it to 85.

When researchers are studying mental disorders, people from older generations may have died or already overcome their disorder by older adulthood.

“The people that we lose before they meet older adulthood means that we don’t have really good data on — what do the trajectories look like? How are they changing? What do some of these diagnoses really clearly look like in older adulthood?” Bloesch said.

“The preventions themselves are similar across the board. The risk factors are different," said Chris Baeumler, crisis team supervisor for Central Michigan Health.

He said older adults, especially men, have higher lethality when they attempt suicide. They plan it out rather than acting impulsively.

Older adults are less likely to seek the help they need for crisis care, he said. But if they do, they can end up seeking the wrong kind of treatment by admitting themselves into a mental hospital when it might not be necessary, "which inevitably puts them in a greater risk for completing suicide because, more often than not, people feel defeated when they come out of a mental health hospital," Baeumler said. "They’ve had these chronic suicidal thoughts, or these depressive thoughts, and it’s not being fixed through medication.”

Older adults can feel like a burden, he said. A tendency that’s increased during the COVID-19 pandemic.

“We very much isolated them and kept them away from everybody, for a good reason," he said. "But I think the unintended consequence of that was bringing around those thoughts of distorted belonging.”

Finding the right medication for a mood disorder is often a challenge. Different people respond to different treatments. Medicare, which insures many older adults, does not offer much flexibility.

“The only chance they can change their medication plans is during the open enrollment period," said Bob Callery, supervisor for the Michigan Medicare and Medicaid Assistance Program in Grand Rapids.

Medicare beneficiaries can run into barriers if they need to change medications.

If a prescribed drug is out of formulary, the official list of medications that are covered in a plan, then the patient would have to pay full cost unless they get an exemption, he said. But it still doesn’t cover the full cost.

“People will flat out tell me, ‘You know what? I can’t afford that, that medication. I’m not gonna take it.’ We see that with all types of medication," Callery said.

There has been some improvement to lowering costly barriers to mental health services. For example, Dr. Emily Bloesch said telehealth has improved conditions for some people.

Younger generations might not run into the same barriers as older generations, she added. In recent years there has been a greater discussion of mental health within families and in popular culture. Communication breaks down barriers. The hope is that barriers will fall quickly so older adults who struggle can still find peace of mind.