Mental Health in Aging Services

The bulk of mental and behavioral health services for older adults is focused on symptom management of Alzheimer's disease and dementia, which is understandable, given the vast prevalence of these conditions among this population and the amount of support these conditions warrant (see the guidance article Dementia Care in Aging Services for more information). However, the needs of older adults who suffer from depression, anxiety, and other nondementia mental health illnesses have historically fallen to the wayside, often due to a lack of trained professionals to address mental health needs in older adults (e.g., geriatric psychologists and psychiatrists), the reluctance of residents to discuss emotional difficulties, the lack of resources aging services organizations have to support targeted mental health programs, and even the common misperception that emotional and physical issues are merely par for the course as people age.

Addressing these needs in aging services organizations requires a comprehensive approach that exceeds offering residents mental health services. Aging services staff must be able to acknowledge the widespread prevalence of mental health problems in their residents; recognize risk factors; understand the organization's pathways to intervene, diagnose, and treat mental health problems; and be able and ready to set residents on an established pathway—tasks that many staff members may not be adequately trained to perform.

Dementia Care in Aging Services​

Analyzing the prevalence of mental health problems in older adults has historically been challenging. For one, symptoms of depression, anxiety, and other conditions may manifest differently in older adults compared to younger individuals. For example, older adults may be more inclined to acknowledge physical symptoms such as body aches, sleeplessness or insomnia, and poor appetite, rather than emotional symptoms such as sadness, anxiety, crying spells, issues with self-worth, and social isolation. The challenge is also exacerbated when residents and physicians are dealing with complex, comorbid, or chronic physical illnesses that make recognition, assessment, and diagnosis of mental health disorders much more difficult due to overlapping or overshadowing symptoms. (1)

A 2012 National Academies (formally the Institute of Medicine) report acknowledged minimal availability of data on prevalence, but suggested that at least...