Data from the CDC shows just how pressing the issue is: More than 41,000 people in the United States die by suicide each year, making it the 10th leading cause of death among adults. Tragic and complicated, suicide leaves families and friends looking for answers—and wondering how it could have been prevented.
We should be motivated to address this major public health concern every month of the year. September, which is Suicide Prevention Awareness Month, is an even more opportune time to get the greater public involved.
Lately, I’ve been thinking more about the issue. Suicide doesn’t discriminate—people of all ethnicities, ages, and genders are at risk. Yet when we talk about suicide prevention, there is a “forgotten” demographic: the elderly population.
Is suicide in elderly populations a major concern?
Yes, it’s a huge concern. It must be better addressed.
Adults aged 65 and older have a high rate of suicide. Those 85 and older have the highest rate of suicide among adults.
This may come as a surprise to many people. While great steps have already been taken to help seniors, I believe we can do more.
To help the mental health of our seniors, we first must understand why it’s happening and identify roadblocks to getting them the services they need.
Why the elderly population is the “forgotten” demographic?
Older people today grew up in a time when mental health services were cruder. Lobotomies were actually a legitimate alternative treatment for mental illness, in addition to other barbaric practices, like insulin shock therapy.
Imagine learning about these treatments as a teenager or young adult. That would lead to negative connotations about mental health services.
There is still a stigma about mental health illnesses within the general population. Among the elderly population, that stigma is even stronger. Not only are older adults fearful of being judged by their community, they also self-stigmatize.
This makes older adults less willing or even fearful to seek mental health services. As noted in a study carried out by leading mental health experts, a high prevalence of stigma leads to poorer adherence to medication and treatment regimens.
Additionally, as Dr. Jo Anne Sirey, a leader in the field of aging and mental health, notes, “depression is often not well detected in older adults. It’s mistaken as a natural part of aging. Depression is not a natural part of aging.”
Seeing depression as just part of growing old leads to it being ignored by friends and family, and even the person suffering from depression. More education and effort is needed to notice when something’s not right.
Another reason is that mental health services aren’t accessible enough for older adults. We need to be going where they are, especially considering the barriers that already exist
Just consider these statistics on the problems facing the aging population when it comes to getting mental health care:
While 18 to 25 percent of elderly people need some form of mental health care, only 3 percent of all Medicare reimbursement is for psychiatric treatment.
Elderly people account for only 6 percent of community mental health services, but represent 15 percent of the population.
Clearly, the services provided don’t meet the need. A change in the delivery method is required.
Why is the elderly population more likely to die by suicide?
Given the barriers to elderly individuals receiving mental health treatment, one of the main reasons suicide is more likely among this demographic is that they don’t get the support they need. More needs to be done at all levels to prevent this tragedy.
So, why do older adults become depressed?
Research has shown that physical illness increases the risk of developing depression. Physical illnesses do become more common as you get older.
In addition to physical illness causing mental illness, experts have found other risk factors in late-life suicide, including the fear of becoming a burden, social disconnection, and the inability to function in daily life. All of these can lead to depression and suicidal thoughts, if not detected and addressed.
As Dr. Yeates Conwell, a psychiatrist with the University of Rochester, says, “things that remove older people from social groups,” such as isolation and retirement, “leave them vulnerable.”
It’s also important to remember that many people struggle with depression throughout their lives. When they get older, that depression may feel even more unbearable—and they may not do what’s necessary to address it.
How can suicide be prevented in elderly populations?
As Dr. Sirey attests, older adults may just see depression as part of growing old, that it just comes with being physically limited or ill. The fact is depression shouldn’t be accepted as a part of growing old.
First, those in consistent contact with the elderly person, like family or primary care providers, should take suicidal talk or signs of depression very seriously. When an elderly individual talks of being a burden to others, begins withdrawing from activities, or seems disinterested in life, we should begin finding ways to solve their concerns and improve their moods.
Educating the elderly community and those close to them about mental health in a more effective manner can also help increase awareness and detection, and help erode some of the stigmas of mental illness. To do this effectively, organizations and mental health professionals should change the way they talk about mental health issues with seniors.
For example, the Center for Elderly Suicide Prevention has implemented some promising initiatives. Knowing that there is a stigma with depression, the center launched the Friendship Line (instead of calling it the suicide prevention hotline). Operating under the idea that connections are what binds us, the phone line is open 24/7 and handles thousands of calls each month.
Additionally, mental health services should be integrated into senior centers in a natural way. We must go where they are. This doesn’t mean just sitting in an office at the residence and waiting for seniors to enter (people won’t go in if they feel they’ll be stigmatized).
To truly integrate with aging centers, Dr. Sirey recommends that mental health professionals at nursing homes and retirement communities get out of the office and immerse themselves into the community. From chatting with residents and staff at parties to holding informal lectures, there are many ways to provide mental health services without elders feeling like they’re being targeted.
On top of integrating and working with aging centers, mental health experts should focus on a holistic approach. Older adults understand the connection between body and mind, which makes health and wellness programs a great entry point for implementing mental health initiatives.
For instance, yoga studios, aerobics centers, game rooms, cafeterias, and other areas at senior centers where socialization and exercise take place are great for not just improving mental well-being, but also for educating residents about services and resources available to them.
As Dr. Sirey explains, “it’s really all about building relationships” on all sides. Mental health providers and senior centers need an effective, integrated relationship. Seniors need to be connected with one another in their communities. Mental health providers must also establish a trusting relationship with older adults.
A healthier future for our elderly people
The elderly population is rising rapidly. Now’s the time to start discussing ways to prevent suicide amongst this population. We all have a role to play.
The true way forward is for us in the mental health profession to integrate into elderly communities. Become a trusted resource and friend—and getting elderly people the services they need will become much easier.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.