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Global crisis and mental health and well-being of older adults

Published online by Cambridge University Press:  16 February 2024

Helen Lavretsky*
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA American Association for Geriatric Psychiatry
Anne Margriet Pot
Affiliation:
International Psychogeriatrics Association Erasmus School of Health Policy and Management in Rotterdam North-West University South-Africa

Abstract

Type
Commentary
Copyright
© 2024 American Association for Geriatric Psychiatry and International Psychogeriatric Association. Published by Elsevier Inc on behalf of American Association for Geriatric Psychiatry and by Cambridge University Press on behalf of International Psychogeriatric Association. All rights reserved.

Worldwide, the mental health of older people is increasingly threatened. In the times we are currently living, in a world facing accelerating life-threatening and catastrophic conditions, providing support for older people and their families is more important than ever. In addition to the COVID-19 pandemic still fresh on our minds, there are escalating geopolitical tensions throughout the world simultaneously. In addition, we are confronted with climate change and disasters such as extreme temperatures, drought and floods, multiple annual hurricanes, and large-magnitude earthquakes. Crises such as pandemic, regional conflicts, and climate change have been, and are disproportionally affecting the mental health and well-being of older people worldwide, those who are in vulnerable positions because of widespread discriminatory practices.

Several associations focusing on better mental health for older people met at the congress of the World Psychiatric Association in Vienna in early October of 2023. We discussed how we can jointly foster the improvement of older people’s mental health and well-being worldwide. Inspired by this meeting, as representatives of the American Association of Geriatric Psychiatry (AAGP) and the International Psychogeriatric Association (IPA), we would like to join forces to advocate for combatting ageism and reducing stigma of mental illness, especially, in these times of global unrest and chronic stress placed on the systems and resources.

Recent years have made it painfully clear that crisis in one country spreads worldwide and is accompanied by worldwide discriminatory practices against aging adults. During the COVID-19 pandemic, crucial resources have been denied to older people, ranging from vaccination and access to necessary healthcare services to shortage of face masks for their caregivers (WHO, 2021; Chen et al., Reference Chen2022). In several countries, governments decided that older people needed to self-isolate or were denied access to crowded places like shopping malls or public transport. In long-term care facilities, family members and friends were not allowed to join their loved ones, who in many cases died alone with painful death from the COVID-19 infection. The detrimental impact of these measures during the pandemic, such as the risk of social isolation, loneliness, abuse, and decline in mental health and well-being, has been documented meanwhile.

Similarly, during conflicts and wars, older people with neuro-psychiatric conditions are confronted with discriminatory practices. As a report by Amnesty International (2022) describes, older people who are unable or reluctant to flee their homes have a higher risk to live in more or less destroyed homes and to be killed. They rarely receive adequate support for their health, whether they stay at home or are in temporary shelters. Crucial information about evacuation plans is not always accessible for them. Furthermore, older people are susceptible to severe heat waves or other natural disasters (Ayalon et al., Reference Ayalon2023). This may manifest as anxiety, depression, post-traumatic stress disorder, and increased suicidal behaviors. In case of emergency evacuation, older people may not receive the support they need or may even be abused. Our clinical expertise and skills in treating common mental and brain disorders is useful, but as mental health professionals, we need to gear up and gain additional skills to deal with overwhelming trauma, fear of death, consequences of displacement and migration, and prolonged complicated grief in older adults and their caregivers. Global organizations such as the Doctors without Borders, the International Federation of Red Cross and Red Crescent Societies, and the World Central Kitchen among others can come to the aid of those in the conflict zones around the world and provide front-line mental health care.

Our organizations involve health professionals for older adults who are passionate about mental health and well-being as the human right of older people. We must stand with older people and their families. The IPA does this for example via publishing position statements (de Mendonça Lima et al., Reference de Mendonça Lima, Ayalon and Banerjee2023), organizing webinars and sessions at its annual congress and other meetings, and conducting the annual Older Adult Mental Health Awareness Week. This is a ten-day period with daily advocacy from the International Day of Older Persons (Oct. 1) till World Mental Health Day (Oct. 10). For those who have missed it, the resources that were shared this year are still available online: Older Adult Mental Health Awareness Week (https://awarenessweek.ipa-online.org/). In the last year, the AAGP has participated in a number of meetings dedicated to Brain and Mental health of older adults as a human right including holding an AAGP roundtable at the Alzheimer’s Association International Congress in July, publishing the expert consensus statement on Life-Course Brain health as a determinant of mental health in older adults in August (Eyre et al., Reference Eyre, Stirland and Jeste2023), participating in the Brain Health Summit in September of 2023 organized by the American Academy of Neurology (https://www.aan.com/advocacy/brain-health), and planning an upcoming virtual AAGP Brain Health Summit on December 8. Other collaborative activities included our presentations on this topic at the events sponsored by the National Council on Mental Wellbeing and the American Association of Retired Persons, International Psychogeriatrics Association, and World Psychiatric Association (WPA), and many others. At the upcoming 2024 annual meeting in Atlanta, March 15-18, we will offer plenaries with roundtable discussions, our annual Neuroscience Teaching Day, and the entire meeting track dedicated to brain health.

Members of the AAGP, the IPA, and the WPA have worked on joint projects that included a two-day workshop dedicated to mental health of older adults in May of 2023 (https://www.nationalacademies.org/event/05-15-2023/addressing-the-rising-mental-health-needs-of-an-aging-population-a-workshop) that was organized by the National Academy of Medicine and co-chaired by Dr. Charles F Reynolds, and co-presented Dan Blazer, Dilip Jeste, and Perminder Sachdev with the upcoming results being in the report “Meeting the Mental Health Needs of a Rising Older Adult Population” by year’s end. In October 2021, Dr Kiran Rabheru edited the published issue of the American Journal of Geriatric Psychiatry on the triple stigma affecting older adults – ageism, mentalism, and ableism (Banerjee et al., Reference Banerjee, Rabheru, de Mendonca Lima and Ivbijaro2021), which was later echoed by a comprehensive review by Reynolds et al. (Reference Reynolds, Jeste, Sachdev and Blazer2022) invited and published in World Psychiatry. These efforts set the stage to our future collaborative efforts for a long-term collaboration between the AAGP and the IPA in the field of mental health and aging that could include joint webinars, joint sessions at annual conferences, joint publications, sharing lists of contents of the two journals, and other educational efforts and opportunities.

At this time, we call on our members of both organizations to become active advocates for older people, their families, and caregivers. In addition, we also believe that we as professionals in the field of aging and mental health can make a positive impact on the lives of older people who are affected. Our research, clinical practice, education, and training should focus on breaking down discriminatory practice and protecting the human rights to mental and brain health of older adults.

Conflict of interest

The authors report no conflicts of Interest.

Source of funding

The work was partially supported by the NIH grants to HL Both authors contributed to the writing of the manuscript.

References

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