Seniors say doctors don’t provide enough mental health care

Three in four adults 65 and older say they would tell their primary care physicians about feelings of anxiety or depression. But doctors don’t always provide appropriate care to older patients with those conditions, says a survey of more than 1,300 seniors issued Dec. 13 by the John A. Hartford Foundation.

Appropriate, evidence-based care for anxiety and depression includes educating patients about their condition, engaging them in medical care and following up to ensure they’re responding properly to treatment, said Christopher Langston, PhD. He is program director at the foundation, which works to improve the well-being of seniors.

“Depression is one of the most common and burdensome issues in older individuals,” Langston said. It’s unfortunate “that so many older people are still receiving mental health care that does not measure up.”

Forty-six percent of older adults who received mental health treatment said their primary care physician didn’t follow up after prescribing treatment. Thirty-eight percent reported not being told about possible treatment side effects of any medications, and 34% received no information on what to do if they felt worse.

Contributing to the problem is that physicians have limited time to attend to mounting demands, said Indiana internist Christopher Callahan, MD. Another challenge for doctors is that seniors often have multiple health problems and various medications that need to be addressed and adjusted during an office visit, he said.

Primary care physicians “are feeling a little burdened by the magnitude of their responsibility for a whole range of conditions, and sometimes it’s hard to get the [physician’s] attention for this very serious condition,” said Dr. Callahan, director of the Indiana University Center for Aging Research.

He encourages doctors to pay the same kind of attention to mental health problems as they do to chronic diseases such as diabetes. And he recommends that physicians involve older patients in decisions about their health.

“There has been a notion in geriatrics that older adults are less demanding of their care than baby boomers” and that they prefer to leave health care decisions to the physician, Dr. Callahan said. “Those days are fading fast.”

Researchers conducted a survey between Nov. 16 and Nov. 26 on a nationally representative sample of 1,318 adults 65 and older. Survey questions focused on participants’ attitudes toward and experiences with mental health issues.

Researchers found that 20% of respondents had been diagnosed with a mental health problem at some time. Of those individuals, 14% were told they had depression, and 11% were diagnosed with anxiety (link).

More than one in four incorrectly believed that depression is a natural part of aging, and 56% didn’t know that depression doubles the risk of developing dementia.

Among the encouraging findings is that most older adults seem comfortable talking about depression and anxiety, Dr. Callahan said. Two decades ago, that wasn’t the case, he added.

“This survey shows us that older adults are asking for help, and it shows that a lot of primary care physicians and other doctors are initiating treatment,” Dr. Callahan said.