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Older people reluctant to seek mental health support


Older Australians must be armed with more information on how to identify mental health issues and how to access help if they need it, says a psychologist who has studied help-seeking trends among seniors.

Claire Adams

The majority of older people have a chronic health problem, which makes them more at risk of having a mental health issue. Yet many are reluctant to seek the relevant support, often because they don’t see the point.

Chronic conditions such as cardiovascular disease, respiratory disease including asthma, and Type 2 diabetes affect 80 per cent of older Australians.

But more than 40 per cent of seniors with a chronic health issue would be unlikely to seek help for mental health conditions if they needed it, according to research from Edith Cowan University (ECU).

Disturbing trend

Not knowing what’s involved and what to expect is a concern that bothers many older people. They think, ‘will I be vulnerable here?

Researcher and psychologist at ECU Claire Adams, whose PhD study investigated help-seeking intentions for mental health services by older adults living with chronic conditions, says it’s a disturbing trend.

“This is very concerning because this group of people are significantly more likely to experience anxiety and depression than older adults without chronic disease,” she told Community Care Review. “If you’re trying to manage a health problem day in and day out, this is going to have a big impact on how you feel.”

“So there is a large proportion of people who are likely to have mental health concerns yet don’t seek treatment.

“And with an ageing population, this is only going to get worse if we don’t do something about it.”

Adams’ study involved 107 people aged over 65 years from both independent living facilities and the community.

While reasons for not seeking mental health support did include physical barriers to accessing services as well as lack of support from family and friends, Ms Adams found the reluctancy mainly stemmed from negative attitudes towards treatment.

“There’s often this mystical thing around therapy,” she said. “Not knowing what’s involved and what to expect is a concern that bothers many older people. They think, ‘will I be vulnerable here?’”

Overlap between chronic disease and mental health

Ms Adams says mental health problems can also be difficult to self-identify in older adults with chronic disease because there are overlaps between mental health symptoms, physical symptoms and the side-effects of medication.

The older generation also had more hardships when they were younger, which has made them incredibly resilient, says Ms Adams.

“When people get older they think that feeling more irritable or down is a normal part of ageing and they have to accept it, and a lot of older people are used to just getting on with things, which can be a bit of a barrier to seeking help.”

There was a positive finding in the study: if people had used mental health services in the past, they were more likely to do so again.

“What this suggests is that the use of mental health services is a positive experience. We just need to get people to that first appointment.”

The answer, according to Ms Adams, is empowering older people with more information. While promotion of mental health treatment in the community has reached seniors, many remain unsure what it actually involves.

Older Australians need more accessible information on how to identify mental health issues and what steps to take if they have any concerns, and what treatment and therapy might look like.

“We need to help people living with chronic disease to manage their disease and also live relatively happy lives,” she said.

“One way of doing that is to encourage them to seek help if they need it.”

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2 Responses to Older people reluctant to seek mental health support

  1. Ted Wards November 21, 2019 at 4:52 pm #

    Well if you do your research there are no specific mental health services for anyone over 65. Mental health decline is seen as a consequence of ageing, not in response to chronic health conditions as such. Its a well know and documented gap in the health system. Its not just a matter of asking for assistance, its a matter of there being no assistance to ask for something that is not recognised. So its time to recognise older people can suffer mental health issues that are nothing to do with ageing.

  2. Caroline November 21, 2019 at 7:50 pm #

    I hadn’t thought about the overlap between poor mental health + chronic disease although it makes sense after reading the article. Help seeking among older people is a challenge with and without chronic disease.

    I deliberately chose to do a postgrad program in counselling with a focus on older adults (given my years of experience in aged care and continuing) but it’s a challenge to raise awareness about supports for help seeking. I’ve had to volunteer my services to assist older people but the moment monies for services are raised, it seems resistance increases or the service is not required any longer. While the known stigma about accessing mental health services persists, it’s overlaid by an unwillingness to pay for ‘something’ where an outcome is not so clear nor its timeframe easily defined. I find that older people who get supports at home understand that home help or personal care is a cost because someone cleans my bathroom or helps me shower. But counselling? You certainly made the same point, “…Yet many are reluctant to seek the relevant support, often because they don’t see the point.”

    All mental health professionals have a responsibility to share information and recognise that some areas of concerns are better supported by counsellors while others are the domain of psychologists. My view is that older people need to know the differences so that they can make a decision about which MH professional to see. I’m not sure if help seeking would change but education is certainly important.

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