Integrating Mental Health into Primary Care for Elders

Article excerpt

The United States will face double jeopardy with the aging of the boomer generation, Ira Katz stated at a July 28 hearing of the U.S. Senate Special Committee on Aging. Katz, director of the section of Geriatric Psychiatry at the University of Pennsylvania School of Medicine, Philadelphia, cited research showing that boomers are more vulnerable to depression than their parents' generation.

"There are going to be more and more older people facing the chronic medical and neurological illnesses of late life that are the major risk factors for depression," Katz said.

He stressed, "That's why we have to learn to deal with this problem now, or else we're really going to be in big trouble when my [boomer] generation begins to experience these problems."

The hearing came on the heels of the release, July 22, of "Achieving the Promise: Transforming Mental Health Care in America," the final report of the President's New Freedom Commission on Mental Health. One of the six major goals stated by the report is, "Screen for mental disorders in primary healthcare, across the lifespan, and connect to treatment and supports." The report states, "The commission suggests that collaborative care models should be widely implemented in primary healthcare settings and reimbursed by public and private insurers," and adds that this measure "could save lives."

In 2000, 5,306 people age 65 or older committed suicide, Jane. L. Pearson told the Senate committee. Pearson, who chairs the Suicide Research Consortium of the National Institute of Mental Health (NIHM) in Washington, D.C., said the figure represented 18% of all suicides that year in the United States, even though the older population constitutes only 13% of the nation's population. She noted that white males enact 81% of all suicides by elders, a group that needs to be targeted for mental health intervention.

In addition to studies focused on suicide by elders, Pearson testified, research has demonstrated that "late-life depression can be deadly in other ways." She said there is now irrefutable evidence that people with depression who suffer myocardial infarctions or sustain hip fractures "are at significantly increased risk for death. …