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U.S. Department of Health and Human Services Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

Substance Abuse & Mental Health Services Administration


Last Updated: 10/2/2009

SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)

 

Mental Health: It's Part of Aging

Both old age and mental illness have traditionally been avenues for exclusion by our society; and older adults who are faced with mental health problems often face multiple barriers that keep them from getting the help they need and participating fully in their communities.  Sharing life experiences with others may help them to understand they are not alone. Also, becoming involved with others in the recovery process and helping others to heal may be beneficial to one’s own recovery. Ask for any type of help you may need, such as financial, emotional, and medical assistance. Seeking assistance is a step toward recovery and independence. Older adults are a generation of survivors and with the proper support will become even stronger and more capable of facing future challenges.

“Older adults may be fearful of seeking treatment or acknowledging that they have a mental illness for a number of reasons. They worry that if they identify themselves as in need of mental health services, they may jeopardize their health care and their insurance. They also fear loss of financial security and independence, embarrassment, isolation, or being declared incompetent.” (Citation, Mentally Health Aging, http://www.mentalhealth.samhsa.gov/publications/allpubs/sma05-3988/stigma.asp)

If you feel shame because you have a mental health problem, remember:

You are not alone.

Mental health problems are common: an estimated 22.1 percent of Americans ages 18 and older — about 1 in 5 adults — experience a mental health problem in a given year. For example, out of 35 million older Americans, 2 million are estimated to experience depression, and another 5 million show significant symptoms of depression (NIMH); 11.4% of older adults over 55 experience severe anxiety (NIMH). http://www.nimh.nih.gov/healthinformation/statisticsmenu.cfm.

Remember also that people who have mental health problems make valuable contributions to society.

Abraham Lincoln and Winston Churchill experienced depression. Actress Patty Duke and astronaut Buzz Aldrin talk about recovery from manic depression. Nobel laureate John Nash has achieved a lot despite experiencing schizophrenia. Overcoming the stigma associated with a mental illness, seeking help and services, and being part of a support network enable people living with mental illness to reclaim their lives, enjoy meaningful careers, and feel supported and accepted by their communities.

There are many things you can do to be empowered.

  • Connect with others
  • Stay positive
  • Get physically active
  • Help others
  • Get enough sleep
  • Create joy and satisfaction
  • Eat well
  • Take care of your spirit
  • Cope better with hard times
  • Get professional care if you need it

(Source: Mental Health America, http://www.mentalhealthamerica.net/go/liveyourlifewell)

Communication Tips

If you want to talk about a mental health problem with your primary care physician, don’t wait for your doctor to bring up the topic; you may need to raise it yourself. Making the most of the time you have with your doctor is important. Your relationship with your doctor is like a partnership.  Here are some hints to help you communicate more effectively. In addition, you should collect as much information about your illness as you can from the library, reliable sources on the Internet, pamphlets at your doctor’s office, and other good sources, such as the Substance Abuse and Mental Health Services Administration’s National Mental Health Information Center.

  • Share your goals for getting help. Think about whether there are certain behaviors or issues you care about most.
  • Keep an open mind.
  • Recognize that talking about personal issues can be tough, but it can help you overcome them.
  • Be honest. Your doctor can't really help you if you don't share the whole picture. Don't say you're fine if you're not.
  • Share any concerns no matter how small you believe they may be. It makes sense that you should talk with your doctor about your mental health concerns because your mental health and overall health are so closely related.

Other tips for preparing for your visit that may get the most benefit from your visit:

  • Make sure your sight and hearing are as good as possible.

As we get older, it may be harder for us to see or hear. Wear glasses if you need to, and get a hearing aid if that will help. Improving your eyesight and hearing as much as possible will improve your ability to communicate.

  • Write your questions down in advance.

That way, you will have the most important questions with you. Also, bring a list of your medications, including how often you take them and how many milligrams you take. And let the doctors know if you feel they are helping you, and/or if you have unpleasant side effects.  Be prepared to advocate for yourself and your healthcare needs.

  • Be accurate and honest.

You are the best person to provide the information your doctor needs.  Even though your doctor may ask difficult questions it is important for you to be open and honest so that you will receive the best possible care. Your responses, by law, are to be kept confidential.

  • Stick to the point.

Since the doctor will likely be able to give you only a limited amount of time — perhaps as short as 10 minutes — you should get to the point quickly and stick to it. 

  • Ask questions.

Although you will probably not have much time, the doctor’s office is no place for stage fright. If you have additional questions, say so. Also, find out how you can communicate with the doctor after your appointment is over. By phone? Through the doctor’s office staff? During another appointment in the near future?

  • Take notes.

Writing down what the doctor tells you can help you remember more clearly later on. Noting medication instructions is especially important. Double-check with the doctor if necessary. Ask a caregiver or friend to go with you to the doctor, so that they can take notes for you.

  • If the doctor is not helping . . .

Sometimes a doctor and a client may be a bad “fit.” If this happens to you, find out if you can see another doctor.

  • If you are a caregiver of an older adult . . .

Encourage the older adults in your care to be direct and straightforward with their doctors. The more open and honest they are about their physical and emotional health, the better care they will receive.

Bibliography:

Communicating with Your Doctor: Helpful hints to take the anxiety out of doctor visits. Anxiety Disorders Association of America. The Reporter, November-December 2003, Vol. 14, No. 6.
http://www.adaa.org/aboutadaa/newsletter/communicationwithyourdoctor.htm

Talking with Your Doctor: A Guide for Older People.  National Institute on Aging, U.S. Department of Health and Human Services, NIH Publication No. 02-3452, March 2002.

Resources:

American Association for Geriatric Psychiatry: http://www.aagponline.org/

Mental Health and Aging Advocacy: http://www.mhaging.org

Mental Health America: http://www.mentalhealthamerica.net/go/information/get-info/older-adults

National Coalition on Mental Health and Aging: http://www.ncmha.org/

National Mental Health Information Center: http://www.mentalhealth.samhsa.gov/cmhs/

Older Women’s League: http://www.owl-national.org/Welcome.html

The resources named here are neither an exhaustive list nor imply endorsement by SAMHSA or the U.S. Department of Health and Human Services.

 

Free teleconference training on this topic is available at Web site http://www.promoteacceptance.samhsa.gov/teleconferences/archive/default.aspx. Scroll to Addressing Stigma and Discrimination Toward Older Adults for instructions. Also, articles, fact sheets, resource organizations, and other materials on this topic are available at Web site http://www.promoteacceptance.samhsa.gov/audience/adults/default.aspx.

For more information about how to address discrimination and stigma, contact the SAMHSA Resource Center to Promote Acceptance, Dignity and Social Inclusion (ADS Center) http://www.promoteacceptance.samhsa.gov/default.aspx , e-mail promoteacceptance@samhsa.hhs.gov, or call 800-540-0320, a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

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This Web site was developed under contract with the Office of Consumer Affairs in SAMHSA’s Center for Mental Health Services. The views, opinions, and content provided on this Web site do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The resources listed in this Web site are not all-inclusive and inclusion on this Web site does not constitute an endorsement by SAMHSA or HHS.