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Bringing elderly mental health to the fore

Monday, October 21, 2013

Mental Health and the Elderly was the theme of this year’s Mental Health Week which ran from October 6–13. 


President of the Association of Mental Health Officers of T&T, Dr Walt Murphy, has been working diligently to help promote awareness of mental health in local communities, and to help make people aware of the facilities available for those in need of mental healthcare.


According to Dr Murphy, one of the biggest challenges facing the mental health community is the global stigma against receiving treatment. The solution he says, is to make psychiatric care more visible in local communities.


“We try to make the care that we give very available. We have clinics in the communities and we make them accessible by being within walking distance, or short travelling distance of the local elderly population. We have educational sessions to teach both relatives of the mentally ill and their caregivers. We go to workplaces and teach them how to deal with colleagues who may have mental health issues. There are a variety of ways that we’re working towards trying to minimise the stigma,” he said.


In general, geriatric patients are more susceptible to mental health issues due to the degenerative nature of declining health. Sometimes mental health issues can be inherited, making certain people more predisposed to suffering from them. Additionally, outside factors like traumatic injuries or pre-existing conditions like diabetes can impact on mental health. Other issues like malfunctioning thyroid glands, loneliness, and drug abuse can be large contributors.


“As life expectancy increases globally, there is a greater window for the development of mental health issues, especially in the later years. Changing family structures and bereavement at the death of a loved one can have a significant impact on the older person who is not as agile or financially capable as when they were younger.” 


Mental Health Week served as an opportunity for the community at large to gain a more familiar understand of how mental health can affect the elderly. 


There were a number of discussions about mental health and the older adult. The association targeted caregivers and the relatives of mentally ill older adults. A lot of information was passed on about how to interpret behaviours of older patients, and how to respond to erratic behaviour.


Dr Murphy also said that the mental health officers, working out of the St Ann’s Psychiatric Facility, often do work to directly educate patients who are mentally ill, and to guide them in appropriate ways to behave while out in the community. A major issue is remind patients of the importance of taking their medication in order to avoid exacerbating their circumstances.


According to Dr Murphy, sometimes the greatest barriers to helping the mentally ill are the patients themselves, usually because of non-compliance with drug regimens or not following up with medical appointments. 


“We do have some measures in place to deal with patients who need more supervision. Generally, we try to get a relative of the older patient to partner with the mental health officers to ensure that they are getting their prescription filled, and that they have someone working with them. We also do home visits for patients who are bed-ridden or no longer ambulatory.”


Access to medication is another barrier to proper mental health that Dr Murphy is working to overcome. The Chronic Disease Assistance Program (CDAP) allows for most lower end psychiatric drugs to be readily available, but most health centres only have access to broad spectrum drugs. Private pharmacies also do not often carry many mental health medications because the turnover is not high enough to be profitable. Because of this, St Ann’s Hospital is only place where many patients can access more potent drugs, and their inability to get to the facility directly affects the quality of their care.


In addition to providing services for the mentally ill, there are also services available for the relatives of mentally ill older adults. Partnering with the Ministry of Social Development, topic appropriate support can be provided. 


According to Dr Murphy, as a person ages, it is important to be in constant conference with their general practitioner. 


“Sometimes a relative might think the elderly person is having a mental issue, but it is simply medical. A GP can diagnose and give a referral if they suspect that there are underpinning mental health issues. Sometimes the patient may only require counselling, while medication is needed in other circumstances, but the sooner you find out, the better.”


More info


Estimates from the WHO (World Health Organisation) say over 20 per cent of over-60s globally suffer from a mental health disorder. Causes of the mental health epidemic are multiple, including loss of mobility, bereavement, loss of income following retirement, isolation, loss of independence and loneliness.


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