Anxiety, Depression Care in the Elderly Substandard

Pam Harrison

December 28, 2012

Many older Americans diagnosed with depression, anxiety, or other mental health disorders are not receiving treatment that meets evidence-based standards, new national poll results suggest.

The national survey, entitled Silver and Blue: The Unfinished Business of Mental Health Care for Older Adults, which was released by the John A. Hartford Foundation, polled a nationally representative sample of 1101 adults aged 65 years and older. An additional 307 interviews were conducted among adults aged 65 years and older who had had a mental health diagnosis or had had recent feelings of depression or anxiety since age 65.

The survey was published online on December 10 by the John A. Hartford Foundation.

Of the total sample, 20% had at least 1 mental health diagnosis; 14% had been diagnosed with depression, and 11% had been diagnosed with anxiety.

Stigma associated with mental health issues was low among survey respondents — only 13% indicated that they would not tell anyone if they were feeling depressed or anxious.

Public awareness of health risks associated with depression was also low. For example:

  • Only 34% of respondents knew that depression is associated with a doubling of heart disease risk.

  • Only 35% knew that depression is associated with an increased risk of dying from another disease.

  • Only 21% had heard that depression doubles the risk for dementia.

Among those receiving treatment for a mental health diagnosis, 46% reported that their doctor had not contacted them within a few weeks of initiating therapy.

Thirty-eight percent also indicated that their doctor had not told them about potential side effects of antidepressant medications, and 40% indicated that their doctor had not told them how long treatment would take to work.

One third also indicated that their doctor had not discussed different treatment options with them, and 22% indicated that their doctor had not worked with them to decide on the best treatment option.

The majority (73%) indicated that their doctor had not used a survey or questions to measure how they were doing.

Slightly more than one half of the same sample noted that their doctor had not discussed nonpharmacologic strategies such as exercise or social activities that might help improve their mental health.

"Treating depression and other mental health conditions can be very successful, but it is not easy," Christopher Langston, PhD, John A. Hartford Foundation, New York City, said in a release.

"The first drug, the first treatment or a single treatment often doesn't work, [and] it is a needless tragedy that so many older people are still receiving mental healthcare that does not measure up."

The John A. Hartford Foundation is a private, nonpartisan foundation based in New York City.

Public Poll. Full article

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