Sequestered Seniors: Mental Health Advocacy Needs To Include Elderly

India boasts the highest population of older adults it has ever seen – 10.5 per cent of India’s total population is aged 60 or above. By 2050, this share is expected to double to 20.8 per cent, bringing India’s elderly population to 347 million, exceeding the entire population of the United States. This is a crucial time to build robust social and medical infrastructure for an underserved, speedily booming population of seniors. 

Mental Healthcare For Seniors

Older adults, as a distinct demographic, have specific needs and issues that cut across social strata. In 1999, India presciently announced its National Policy for Older Persons, which recommended that mental health services be expanded and strengthened. An updated 2011 policy highlighted the need for special attention to elderly women, whose mental health challenges are further exacerbated by deep-seated socio-cultural biases. With a longer life expectancy, women dealing with the loss of a partner in their twilight years may experience greater social isolation and vulnerability– 50% of women over eighty years of age are widows. 

Now, a quarter of a century and a pandemic later, the aim of improving mental health services for the elderly must be broadened and reimagined holistically. Mental health conditions can affect anyone, but certain demographics are more vulnerable to particular mental health issues. Understanding the social environments and processes that contribute to mental health challenges can shed light on appropriate interventions to improve outcomes at both societal and individual levels. 

The most prevalent mental health challenges faced by senior citizens are loneliness and depression, especially by women. Social and medical factors like ageism, lack of autonomy, social isolation, and chronic illnesses make older adults particularly susceptible to anxiety and depression. 

The eclipse of the elderly from social discourse has hindered the dedicated development of elder mental health infrastructure: stigma surrounding mental health disorders remains high, and more urgently, India is facing an evident paucity of mental health practitioners for geriatrics. With a holistic strategy to address mental health concerns for seniors, families and care providers can empower older adults to prioritise their mental well-being.  

Fostering Wellbeing 

An emerging strategy for elder mental health has been to pivot focus from clinical resources to a more informal approach to foster emotional well-being. Workshops, group discussions, and seminars provide a ‘softer’ avenue to spark dialogue about mental health among seniors, which can include case studies, visualisation exercises, and practising mindfulness under the guidance of a mental health practitioner. 

Broaching complex subjects like mental health can be made simple and engaging for older adults through emotional well-being workshops and interactive sessions, especially in group settings. Focusing on positive steps like gratitude, journaling, exercise, self-regulation techniques, and discussing issues as a group can build strong habits that foster sound mental health. This also works to destigmatize mental health discourse and care, allowing those who need clinical aid to become comfortable enough to willingly seek out help. 

With elders, it’s pertinent to understand the deep influence of social factors on mental health outcomes. Aside from addressing the social conditions that worsen the quality of life for seniors, governments and care providers must tailor mental health interventions to the positionality and particular concerns of older adults. Concerted action by policymakers, doctors, therapists, care providers, and family members is essential to build mental health infrastructure for India’s senior citizens.  

Social Interventions 

Many seniors grappling with depression, loneliness, or anxiety may not even have the vocabulary with which to define their experiences or know how to seek assistance. In addition to improving the availability and accessibility of clinical mental health services, policymakers and care providers must create favourable conditions for seniors to take charge of their mental health. Social interventions can provide significant support: by investing in creating communities for senior citizens, making elderly-friendly infrastructure, and designing relevant recreational activities, governments and organisations can meaningfully improve the quality of life for senior citizens, alleviating common mental health challenges.  

By narrowly understanding mental health as a purely medical issue, we ignore its vast social dimension, especially for vulnerable demographics like the elderly. Social interventions for mental health support must be developed on par with geriatric medical services. Addressing the social factors that exacerbate mental disorders can improve outcomes for entire communities, such as senior care homes providing invaluable social spaces for seniors to interact with one another and engage in relevant activities for leisure and health. Such dedicated spaces for the elderly, like assisted care services and senior care homes, can be an especially effective way to implement social interventions for seniors at scale.  

Long-term collective efforts like combating ageism, making public spaces elderly-friendly, and fostering agency among seniors will have deep, far-reaching benefits for elder mental healthcare. This can be achieved by improving social conditions and creating dedicated spaces for seniors that allow them to find community and avail of integrated services. With a rapidly ageing population, India must take a holistic approach to mental healthcare and prioritise interventions that will allow its older adults to live vibrant, resilient lives. 

Authored By Dr. Namita Mittal - Medical Superintendent at Antara Assisted Care Services Ltd