Why Don’t Seniors With Depression Get Treatment?

A new national poll found that almost two out of three Americans age 65 or older who are worried about having depression won’t go get treatment and a third believed they could just “snap out” of their depression on their own.

The poll was conducted by GeneSight Mental Health Monitor and surveyed more than 1,000 adults over the age of 65 on their attitudes towards depression.

The survey found that 61% of respondents who said they were concerned they might have depression would not treat it because their “issues aren’t that bad” and about 40% of them think they could manage depression without help from a doctor.

This is nothing new. Experts have long said that acknowledging psychological problems still carries a stigma in older generations, and research has found that this is particularly among rural residents and Black Americans.

“I’ve found older adults have a very difficult time admitting that they have depression. When they do acknowledge it, they are still reluctant to start treatment for a wide variety of reasons,” said Dr. Parikshit Deshmukh, CEO and medical director of Balanced Wellbeing LLC in Oxford, Florida, which provides psychiatric and psychotherapy services to nursing and assisted living facilities.

“The ‘pull yourself up by your bootstraps’ mindset of some seniors and reluctance to talk about mental health are hindering them from getting the help they need – especially now when the pandemic is having an enormous impact on the mental health of older Americans,” added Mark Pollack, chief medical officer of Myriad Neuroscience.

“People will seek treatment for conditions like heart disease, high blood pressure or diabetes. Depression is no different. It is an illness that can and should be treated.” 

But it’s not just individuals reluctance to get treatment that’s impacting seniors access to mental health care.

Currently more than 20% of adults aged 60 and over suffer from a mental or neurological disorder. The most common being dementia and depression, according to the World Health Organization.

Additionally, men over the age of 85 have the highest suicide rate out of any demographic group.

And that data is before we take into account the rising mental health problems due to the ongoing pandemic.

However, when it comes to getting support around 15% of adults over the age of 65 have said they “rarely” or “never” get adequate amount of social or emotional support they need.

“In my experience, there is a commonly held view that depression is a normal part of aging; it is not,” said Deshmukh.

Research has found that older people with depression are less likely to get referred for psychological therapy as well as are just generally often overlooked and under-diagnosed when it comes to mental health issues such as depression.

Additionally, getting insurance coverage for psychotherapy is increasingly difficult for people to access care.

Medicare is the primary insurance provider for approximately 60 million Americans and that figure is expected to reach 80 million by 2030 but a recent study published in the journal Medical Care Research and Review found that only about 36% of mental health providers accepted new Medicare patients. This is compared to 83% of physicians who accept new Medicare patients.

Another study published earlier this year noted that Medicare also doesn’t reimburse patients who go to licensed professional counselors or marriage and family therapists. Professional counsellors and marriage and family therapists makeup almost half of the mental health care provider workforce.

So even if older adults wanted to get help it’s not that simple. As the authors write in their paper: “the policy unduly limits the accessibility of counseling services to people over age 65”.

While a new bill is currently trying to change that it’s still going through the House.

So with all that in mind it’s no wonder older adults don’t get the treatment they need for their mental health issues.

But if the seniors manage to overcome their reluctance and all the other hurdles in their way so they actually get into see a psychotherapist, the good news is that older people do equally well in psychotherapy as younger adults.

So that’s something.