Rehabilitation and Mental Health Practices for an Aging Population in the U.S.. (Editor's Comment)
Harley, Debra A., Dixon, Charlotte G., Moore, Corey, The Journal of Rehabilitation
Individuals in the U.S. are living longer due to technological advancements, improved medical care, and general improvements in the standards of living. Persons age 85 and older constitute the fastest growing segment of the U.S. population and are projected to double to more than 70 million by 2030 (Administration on Aging, 2002). Racial minority persons, who constitute the fastest growing segment of the elderly population, are expected to increase more than 500% by the middle of the 21st century (Scharlach, Fuller-Thomson, & Kramer, 1999). Along with the increased life expectancy of many U.S. citizens come concerns and issues regarding the future of the aging population and increased incidence of disabilities among persons who are aging. A large portion of the literature regarding aging Americans have focused on the impending retirement of the "baby boom generation" and the impact of their retirement on various aspects of American life (i.e., social security, employment, long term care, etc). However, limited attention is given to the mental health of this population.
Aging Americans are very heterogeneous, possessing significant within and between group differences. For example, the elderly of today and those of tomorrow constitute substantially different cohort groups across race and ethnicity, historical oppression, immigration and migration status, and various lived experiences. Historical and contemporary realities that these cohorts have experienced and will experience will play a major role in shaping their perceptions of the important issues, and also will directly relate to their ability to deal with such issues. A keen awareness of within and between group differences is paramount in understanding the impact that current issues will have on the lives if aging Americans, particularly those with disabilities, and is essential to the development of adequate and appropriate service planning and delivery.
The field of rehabilitation may be confronted with a consumer population that is older, remaining in the workforce for longer periods of time, and require more services across different venues. An aging consumer population ushers in new and unique challenges for public and private sector rehabilitation agencies, rehabilitation educators and researchers, and rehabilitation practitioners. Therefore, dedicating a special issue of the Journal of Rehabilitation is timely, and offers information to a wide readership within rehabilitation (e.g., counselors, consumers, supervisors, and students) and related disciplines (e.g., counseling, mental health, and social work).
In their article on contemporary issues facing aging Americans, Charlotte Dixon, Michael Richard and Carolyn Rollins explore varied and complex issues including financial instability, employment concerns, long-term care issues, grand-parenting issues, victimization and abuse, and mental health issues. In addition, the authors explore the role of rehabilitation and mental health counseling professionals in meeting the needs of aging Americans. In the next article, Elizabeth Sweet and Malachy Bishop describe three prevalent mental health problems among older consumers: cognitive functioning, depression, and anxiety disorders. Also, the authors identify the scope of the problem of mental health, mental illness, and aging. Finally, Sweet and Bishop provide recommendations for serving this population.
Susan Kelly addresses prevalent mental health disorders and issues of comorbidity and functional disability in the aging population. Prevalent psychopathologies such as cortical and subcortical dementias, depression and related mood disorders, anxiety and phobias, and substance abuse are discussed. …