Earlier this month, the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, started a collaborative venture with HelpAge India to provide psychiatric support to the elderly. Named ‘Sarthak’, this will be a community-based initiative for the mental well-being of the elderly. As part of the initiative, training will be imparted to nurses, healthcare workers and volunteers on geriatric mental health.
It is a laudable initiative and effort, considering that senior citizens are a vulnerable population. According to WHO, due to population ageing, the number of senior citizens with mental health disorders is expected to double by 2030. Older people constitute around 8.6% of the total population, and this number is on the rise with an increase in longevity. As Dr Minakshi Manchanda, the associate director of psychiatry at Asian Hospital, points out: with the decline of the joint family system, senior citizens often end up leading isolated lives, putting them at risk for poor mental health. Additionally, those diagnosed with a serious mental illness like schizophrenia are living longer and often face age-related changes prematurely. “Multiple comorbidities that usually accompany age-related conditions further compromise their well-being," she adds.
Unfortunately, as Dr Neerja Birla, the founder and chairperson of Mpower, an initiative of the Aditya Birla Education Trust, points out, older people are often resistant to seeking treatment for mental health. Often, they come from a social background where mental health was heavily stigmatised and where they're used to adjusting or suffering stoically, she points out. “Due to a lack of awareness and acceptance, they themselves would not attribute their suffering/symptoms to mental health concerns,” she says, adding that, also, since many senior citizens are dependent on their children or other relatives, they do not want to be seen as a financial or emotional burden. “In our own families, we often see that parents, grandparents or elderly relatives do not like to draw attention to any mental distress they may have, even though they may be quite vocal about physical health concerns.” And yes, a lack of awareness about mental health, in general, makes the situation worse. Dr Shabnam Mir, who heads Clinical Services at Antara Senior Care, says, “This leads to either low footfall at the hospitals or delays in seeking help."
On the positive side, however, experts say that the pandemic led to a shift in attitudes amongst the elderly when it comes to seeking help for mental health issues. Antara Senior Care, a retirement home for senior citizens, said that 57 per cent of their residents reported having experienced some mental health issues during the pandemic. While a lot of them didn’t seek care, they were aware of their issues. Dr Birla too agrees that MPower is starting to see that the geriatric demographic, too, is becoming more open to accepting the reality of mental health concerns and seeking help for it since the pandemic.
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When it comes to encouraging the elderly to seek help, empathy and cultivating a humane approach play a huge role. Elaborating on this aspect, Dr Birla says, “As people get older, their social circles shrink, and many of them no longer have the same level of support and interaction with their peers that they did when they were younger. We've seen that peer support groups can have a very positive influence on the lives of seniors,” she says, adding that when people feel more supported, they are likely to be more vocal about their mental health. She adds that there is a need for outreach efforts at the community level to create awareness about mental health concerns among senior citizens. “Apart from normalising mental health and help-seeking behaviour, I’d recommend that awareness programmes also ought to include the caregivers and relatives of senior citizens, so they know about symptoms and behavioural changes to look out for," she says