[00:00:00] Regina Koepp: Did you know that nearly one in four older adults, that's people 65 and older, have a mental health condition like depression, anxiety, substance use disorder, even a dementia disorder. Yet most go undetected and untreated. This is because there are many misconceptions about what's typical with older adulthood and not that keep older people from getting the help they need.

So in today's episode, I'm going to break down the unique mental health needs of older adults, and I'm going to do that by debunking myths. So we'll talk about what's typical among older adults and not, and explore how mental health treatment can be just as life changing at 80 years old as it is at 30.

So stay tuned and discover how you can make a real difference, not only in the lives of older adults, but in your own future life as well.

Welcome. I am Dr. Regina Koepp. I'm a geropsychologist and the founder of the Center for Mental Health and Aging.

Let's talk about why it's so important to address the mental health needs of older adults. The older adult population in the United States is growing dramatically. By 2034, there will be more people 65 and older than children under the age of 18. Yet, mental health providers are grossly under trained to meet the mental health needs of older adults.

In fact, less than 5 percent of mental health professionals, and I would even venture to say significantly fewer than that, Specialized with older adults, and so I aim to change this. I do this through this public education and also through professional continuing education.

, what happens when mental health conditions go undetected and untreated among older adults?

This is significant. When mental health conditions go undetected and untreated among people 65 and older, if they have a medical problem, that medical problem tends to get worse. They tend to need more medication for that medical problem. They have higher rates of medical hospitalizations, higher rates of ER visits.

They, because they're using more of the medical system and more medications, their medical costs are increasing. So there are more financial expenses and out of pocket costs that also might result in the greater need for caregiving. And so there might be more caregiving costs or financial strain.

In addition , not addressing mental health conditions among older adults like depression and anxiety.

increases the risk for dementia disorders. If you'd like to learn more about this, just check out the video I did last week. I'll also be exploring this in future episodes. So, if we don't treat mental health conditions, Like substance use disorders, depression, anxiety, and so on, the risk for dementia increases. And then an increased risk for suicide. And older white men have the highest rates of suicide. And so we can do things to help prepare and prevent these negative consequences from happening and help people at every stage of life live their best life.

And the good news here is that mental health conditions are highly treatable among older adults, but we have to detect them first.

And so that's where you come in. My hope with this channel is to help give you the tools that you need to identify mental health concerns when they arise in the older people that you're caring for, whether, whether that's professionally or personally, and then to bridge them to needed care.

So one way that we can begin to address the mental health needs of older adults and begin to identify and detect mental health conditions among older adults is to understand what misconceptions exist as it relates to mental health for older people. There's a common misconception that as we age we become more anxious and more depressed. And this is actually not true. As we age, the tendency is to become more psychologically resilient.

And this isn't like older people are resilient and you are not. This is each of us become more and more resilient. The tendency is to become more and more resilient as we age. And that's because With life experience and with more exposure to adversity and challenges, we build our resiliency muscle. And so actually it's a misconception that as we age, we become more depressed and more anxious.

And so if you're noticing signs of depression or anxiety or substance use disorders, or insomnia, or sleep disorders, if you're noticing these symptoms related to conditions like this, or even cognitive impairment, because dementia is not a normal part of aging. It's more common among older adults, but it's not normal.

And so if you're noticing signs and symptoms, encourage the person to get connected with their primary care provider to rule out. any medical conditions that might be creating mental health effects.

, Here's another misconception that keeps older adults from getting the mental health care that they need. There's a common misconception that We're impervious to change as we grow older, that older adults don't change, they're set in their ways. And in fact, the research shows that this is not true, that older adults are just as capable of change as other age groups, even in psychotherapy.

And so the mental health treatment is as effective for older adults as it is for younger age groups. And when it comes to substance use disorders, there's some evidence that shows that older adults have better outcomes, even a year after substance use treatment ends, than younger age groups.

Don't believe the idea that older adults are resistant to change or set in their ways and not willing to change. That construct is more driven by personality than by age. It's not determined by age. So, if you're concerned, lean in, share your concern, and encourage your older client or your older loved one to connect to their primary care provider and begin to address how to get mental health conditions treated.

Another reason that mental health conditions tend to go unrecognized and untreated is that there is gross under education when it comes to educating our workforce, our mental health workforce, our physician workforce, our medical workforce on understanding and addressing the mental health needs of older adults. Most graduate schools do not provide much training related to mental health care for older people. Do not much provide much training on what's typical with aging and not, differentiating depression from dementia, and so on. And what's very complicated is that as we age, our risk for physical health problems, medical problems, increases. And medical problems can affect our psyche. There's a statistic that more than 80 percent of people 65 and older have at least one chronic health condition. And when we have a chronic health condition, our risk for depression is higher. Also, when we have a medical condition and we require assistance with dressing or grooming or transportation and other resources like that, our risk for depression increases as well.

And so there are risk factors that we need to be paying attention to, especially when older adults have a new medical diagnosis or a chronic health condition that's worsening. And so it's really important that we are screening people in medical clinics for mental health concerns like depression and anxiety and, and bridging them to care.

Also, what can be very complicated with differentiating is this a mental health condition or a physical health condition is that often for many older people, they might describe their mental health concerns in physical ways or as physical complaints like more chronic pain. So, they might have chronic pain and then talk about their mental health distress in similar terms as they would with chronic pain or so that they have both distress and chronic pain, but that there's not necessarily the language to differentiate them or they might complain of headaches or stomach upset and, and so the mental health symptoms and the physical health symptoms can sometimes merge in the way that some older people talk about it.

And that's because In many older generations, there's a significant stigma, which is potentially shame or fear of rejection or belittlement if describing mental health concerns. And so, as a way to accommodate that, People will often describe their distress in physical terms and so many older adults, and this is not true only for older adults, other people do this as well but describe, can describe their symptoms in physical terms.

And so if we're not really tuned in or listening or understand or have a training of how to identify and differentiate that, or to offer language for that, then we might miss it. And so that's another reason why mental health conditions often go undetected and untreated among older adults is, is that we just take descriptions at face value and we don't sort of get curious and offer other ways of understanding or highlighting the distress.

So for many older adults I think sometimes because of this, because it might be more comfortable to talk about physical health complaints than mental health complaints, we overlook mental health concerns and we don't offer our older clients the opportunity for an integrative approach to their care.

We might tend to focus on the physical health rather than on integrating physical health with mental health, spiritual health, and psychological health, cognitive health. And so all of those are working together and because it takes more time to integrate all of those components of health we might be more likely to miss it or to overlook it or not make time for it.

Another barrier to older adults getting the mental health care that they need. There's also a common misconception that older adults are all alike. And so, there's an idea that older adults are similar in their demographics, like how they live, and we think, when we think of a baby boomer, we think of a certain term, and that really is reductive and belittling, and it dismisses all the rich and nuanced experiences.

Experiences that people with diverse identities bring to the world and our lives. And so you know, older adults identify as LGTBQIA plus and by 2030, the older white population will increase by 39 percent whereas the older BIPOC population. So BIPOC is black indigenous people of color will increase by 89 percent and by 2050. Older BIPOC people, so people 65, BIPOC folks who are 65 and older, will comprise more than 42 percent of the population 65 and older.

We're an increasingly diversified world. Also, older adults may be more likely to have an acquired disability, like hearing loss, visual impairment. Physical impairments that require walking devices . And so we need to be thinking about ability and disability. racial and ethnic diversity, religious and spiritual diversity, diversity in all of its forms, sexual orientation, gender identity. And so it's an incumbent upon us as mental health providers and aging services professionals to create Healing spaces where people feel a sense of belonging and like they can contribute, and that includes honoring diversity in all of its forms. And this is particularly important because when people experience racism and discrimination and have the stress of being minoritized in a community.

The risk for dementia and other health complications increases and that's because there's an additional load, an additional stress that people should not have to carry. And the good news here is that we can change it by challenging our biases and discriminatory thoughts. This is another example of how mental health conditions go undetected and untreated and how certain groups may be left out of mental health care and why we need to be mindful of including them. And also understanding barriers that are unique to certain communities in terms of trust and mistrust because of histories of discrimination in mental health care.

I mentioned earlier that mental health conditions are highly treatable among older adults, that we have to debunk that myth that older adults are rigid and won't change, that's entirely untrue, that we need to create spaces where people belong, that we need to challenge ageism, which is bias and discrimination based on age, challenge stigma, which stigma is like the scarlet letter, that if you are carrying a a letter of mental health condition that there's a risk for rejection and discrimination.

And we need to challenge that as well and open our clinics and resources to include older adults.

Another barrier is ageism with ageism in mental health care is that many mental health providers do not work with older adults and do not have training to adequately meet the mental health needs of older adults or understand what to do if an older adult is presenting to memory loss in your clinic.

And so, I want to help you address that.

I want every mental health provider to have the tools to meet the mental health needs of older adults. You can see by the statistics that I shared that not offering treatment is not an option.

It's just making people sicker. It's creating despair and distress where there doesn't need to be suffering. And you have an important role in changing this. So if you'd like five expert strategies for addressing memory loss in therapy, this is for mental health providers. You can get access to this free training. It will be emailed directly to you. You go to MentalHealthAndAging. com forward slash clarity or you can click the link wherever you're watching this video.

So MentalHealthAndAging. com forward slash clarity. clarity. This is because I want you to go from confusion to clarity when it comes to addressing memory loss in your practice. So you're going to get a 10 minute video with a workbook, and then the next day you're going to get another video with more information and another workbook as well to help you in your practice.

I want you to have all the tools that you need to meet the mental health needs of older adults because it is only with your help. that we can meet the mental health needs of older adults. I'll see you next time, same time, same place.