Mental illness among elderly Americans expected to become a greater concern

Fifteen million elderly people are expected to suffer from some kind of psychiatric illness by the year 2030, but managed care and mental health professionals are not prepared for the crisis, say researchers.

That conclusion was explained in the report, "Consensus Statement on the Upcoming Crisis In Geriatric Mental Health: Research Agenda for the Next Two Decades."

According to the report, current research efforts, funding levels and numbers of geriatric-trained mental health personnel cannot meet the future demands of this growing population. In the report, lead author Dilip Jeste, MD, professor of psychiatry and neurosciences at University of California, San Diego School of Medicine, says the lack of medical and community services and inadequate training of caregivers and geriatric mental health specialists will have dire effects on the elderly population over the next 10 years.

Not only will health-care professionals have to treat people who develop late-onset mental illnesses commonly associated with aging, but they will also treat people who have lived with a psychiatric illness--such as schizophrenia, depression or substance dependence--for most of their lives. They will also be faced with treating patients who have been underdiagnosed and inadequately treated. Other barriers to care for the elderly include ethnic and cultural differences between elderly patients and physicians.

To counteract this crisis, Jeste and his colleagues recommend increasing psychotropic drug studies as well as studies of psychosocial and behavioral therapies, developing more training programs in geriatric mental health for primary-care clinicians and researching the decision-making process in the elderly. They also call for mental health professionals to create practice guidelines and assessments, to demonstrate ways caregivers can handle elderly patients, especially those with dementia.

The report was based on a March 1998 workshop attended by representatives from several universities and organizations. The full summary of the workshop was published in the September issue of Archives of General Psychiatry (Vol. 56, No. 9, 848-53).

--M. Waters



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