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Mental Health Older Adults Statistics
Pensioner Geneviève Dupaquier, 90, and student Dilara Ekinci, 25, leave a bench after chatting at the Jardin du Luxembourg in Paris on February 19, 2021. "Paris en compagnie", a program he organized designed to address the isolation and distress experienced by the elderly in France . Photo: Christophe Archambault/AFP via Getty Images
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Almost all US adults over age 65 have mental health coverage through Medicare enrollment, which covers annual depression and substance use screenings, outpatient therapy and counseling services, among other services.
But is that coverage enough to ensure that the mental health needs of older Americans are met, especially as cases of depression and other mental health disorders have increased during the pandemic?
Drawing on survey results of more than 18,000 adults aged 65 and older in 11 high-income countries, we compare Medicare beneficiaries in the United States with older adults in other high-income countries on mental health burden, access, and affordability of mental health . need health care and experience financial hardship.
(When sample size permits, we also show how these results compare for different races and ethnicities within the US)
Demographics And Health Insurance Coverage Of Nonelderly Adults With Mental Illness And Substance Use Disorders In 2020
The survey was conducted by research firm SSRS and Commonwealth Fund international partners, and was conducted between March and June 2021. It is the latest in a series of Commonwealth Fund international health policy surveys, which are conducted annually to enable cross-national comparisons between the US and US- and other high-income countries.
Older adults in the United States are the most likely to report a clinician diagnosis of depression, anxiety, or another mental health condition. One in five Medicare beneficiaries in the US reported a mental health diagnosis, compared to 5 percent of older Germans.
But when looking at America's racial and ethnic groups, there were clear differences. A significantly higher proportion of Hispanic/Latinx Medicare beneficiaries reported having a mental health diagnosis compared to white or black beneficiaries. Older Black adults were least likely to report such a diagnosis, although studies have found that help providers are more likely to underdiagnose Blacks with mood disorders than other adults.
Self-reported emotional distress may provide a better understanding of the actual mental health burden experienced by older adults. This is because not everyone with a mental health problem seeks help from a health professional, whether due to cultural factors, financial barriers or other reasons. As a result, many psychiatric conditions are underdiagnosed and undertreated, a problem that may worsen during the COVID-19 pandemic.
Healthy Aging: What It Means To Older Adults
They are particularly elevated in countries where infection rates are high and where strict lockdown measures have been imposed. Older adults in France, which locked down for eight weeks before the pandemic began, were the most likely to report emotional distress among the countries surveyed.
While the US is on par with some other high-income countries on this measure, Medicare beneficiaries were more likely to report emotional distress than older adults in Switzerland, Norway, Sweden and Germany. Within the US, significantly more Hispanic/Latinx Medicare beneficiaries—a group hit hard by the pandemic—reported emotional distress compared to white or black beneficiaries.
Commonwealth Fund research defines mental health need as a diagnosed condition such as anxiety, depression or emotional distress in the last 12 months.
Mental health needs were most common among older people in France, the US and New Zealand, followed by Canada, Australia and the UK. Older adults in Germany were the least likely to say they needed mental health care.
More Covid 19 Fallout: Social Isolation Associated With Poor Health And Emotional Distress
When COVID-19 first hit, rates of depression in the US immediately rose, especially among older Hispanic/Latino adults.
In fact, our research found that these users reported mental health needs at higher rates than their white and black counterparts.
Cultural norms and stigma associated with mental illness, as well as institutional barriers, may contribute to differences in the likelihood that people seek mental health in times of need.
Despite having one of the highest rates of mental health needs in the Commonwealth Fund survey, older French people were among the least likely to seek help for their depression, anxiety or emotional distress.
Exploring Barriers To Mental Health Care In The U.s.
Two out of three U.S. Medicare beneficiaries with mental health problems have sought help from a professional and are significantly more likely to receive help from older adults in other countries. The low supply of mental health workers and challenges accessing care in rural areas may also be factors in why not all older adults with mental health needs seek care.
The Commonwealth Fund survey asked older people about times when costs prevented them from accessing health care in the past year, including a health problem but not a doctor's visit; performed the necessary testing, treatment or follow-up; the prescription for the drug was not filled; or missed doses of medication.
Despite the financial protection that Medicare offers, its coverage leaves many older adults in the US exposed to high health care costs.
This is particularly true for users with severe mental health needs who are likely to spend more on health services.
One In Four Older Adults Report Anxiety Or Depression Amid The Covid 19 Pandemic
High out-of-pocket health costs can cause beneficiaries to delay or forgo care, which can lead to poorer health outcomes and increase overall health care spending.
Medicare beneficiaries in the US have one of the highest rates of mental health needs overall. However, they were more likely than older adults in any of the other high-income countries we studied to gamble or delay needed care because of cost. Within the Medicare population, beneficiaries with mental health needs were more likely to receive care compared to those without mental health needs (data not shown).
Fewer than one in ten older adults with mental health needs in the UK, France, Sweden and Germany reported skipping or delaying care because of cost.
Respondents to the Commonwealth Fund survey were asked whether they experienced financial hardship, defined as always or usually worrying or feeling stressed about buying a nutritious meal, paying rent or a mortgage, or paying monthly utility bills, such as electricity, heating or phone service.
Mental Health Among Older Adults Before And During The Covid 19 Pandemic
Medicare beneficiaries in the US were the most likely among respondents to report that they were always or usually concerned about at least one of these costs—with the exception of older people in Switzerland.
Older residents of the United Kingdom and the Netherlands experienced the least material hardship. Studies show that unmet economic and social needs, which are more prevalent in the US than in other high-income countries, may contribute to high rates of mental health needs. This is especially true for low-income adults in the era of COVID-19.
The benefits of a program focused on mental health are particularly important, as our research has shown that older adults in the US, and particularly Hispanic/Latino adults, have one of the highest rates of mental health needs among high-income countries. seek care for their anxiety, depression or emotional distress. These needs are even greater during the COVID-19 pandemic: one study found that more than a quarter of older Americans believe the pandemic has had a significant impact on their mental health.
Although policy changes in recent years have made it easier for older adults in the US to be screened for mental illness and receive outpatient mental health care, many older adults still face significant challenges in accessing and providing services.
Nimh » Depression
Outside of Medicare, mental health problems are often associated with social barriers and social determinants. One study found that a self-reported history of depression was associated with greater unmet need and greater financial hardship for Medicare beneficiaries.
Addressing the social needs of older US adults with mental health problems will likely require collaboration across policy domains.
Most of the countries we studied, including the US, have launched anti-stigma campaigns to change public attitudes towards mental illness. Many, including New Zealand
Campaign, achieving significant success, although it remains to be seen whether the change can be sustained in the long term.
Stress In America™ 2020: A National Mental Health Crisis
Finally, disparities in mental health among American racial and ethnic groups warrant further investigation and policy attention. Older Hispanic/Latino adults are nearly three times more likely to receive a mental health diagnosis than older Black adults. The COVID-19 pandemic, with accompanying social isolation and job loss, as well as fear of changes in immigration policies and “public benefits,” appears to have had a disproportionate impact on the mental health of older Hispanic/Latino adults, regardless of age. .
Studies have found that Hispanic/Latino adults who were born in the US or have lived in the US for more than 10 years are more likely to have a mental illness than those who were born abroad or recently immigrated.
Meanwhile, lower rates of mental illness among older blacks may not be a success story. Stigma, lack of trust in the medical system, and
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