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Foundation Board Members Discuss Challenges and Solutions Facing Older Adult Mental Health Care

Following, three members of the GMHF Board of Directors discuss how they became involved with the Foundation and what they feel are the biggest challenges and solutions facing older adult mental health care today.

Hikmah Gardiner
Ms. Gardiner, the First Vice President of the Older Adult Consumer Mental Health Alliance, is a consumer advocate in the mental health field.

“Mental health care is still scarce in minority arenas. Minorities usually are the last to get the good news. It’s important to engage minorities, since we are a land of many faces and colors and shapes, so that people can take the message back to their communities. That is a part of my role within the Foundation.

“Just being able to get the care is the biggest challenge facing older adults needing mental health care. With everything that is happening today with Medicare, Social Security, and Medicaid, it scares me to think about it getting more difficult for older folks to obtain care. It is just unconscionable. Old folks don’t cry out, as I do, and nobody pays attention to them. That’s one of my jobs—to get folks to notice.

“Let’s take my state of Pennsylvania for example. We have the highest population of 65-plus individuals of any state except Florida and the numbers are growing. Older people are living longer, and I don’t know if society is really prepared for this. We need more lobbying for seniors—we need more Steve Bartels [GMHF Board member] and Hikmah Gardiners. We need to put more money into programs for seniors. Legislators need to be educated more about the needs of older people, as does the general population.”

George Kotwitz
Mr. Kotwitz is a consumer advocate in the mental health field.

“I have been an advocate for older adults for several years, since I experienced a late-life onset of bipolar illness. I began speaking at the National Association of State Mental Health Program Directors (NASMHPD) conferences approximately 10 years ago as a consumer involved in a mental health and aging coalition. I was asked if I would be interested in serving on the GMHF board. I felt the GMHF would be an excellent place to voice my concerns with the present lack of programs for older adult consumers. The Foundation has played an important role in pinpointing specific needs of older adult mental health consumers.

“One of the biggest challenges facing older adults is the idea that it is their responsibility to take care of their own problems without asking anyone for help. My generation was taught to ‘tough it out,’ and my problems were mine to own and fix the best way I could. Today effective treatments for mental illnesses exist, and older adults should not be ashamed to ask for and get the help they need.

“The next greatest challenge is to teach general practitioners to look at mental as well as physical symptoms. Many physical illnesses are exacerbated by the failure to treat depression. General practitioners and their patients would also benefit from education about the different medications available for older adults. And, more attention should be given to the caretaker, who may also be elderly and in need of mental health treatment.”

Martha L. Bruce, MPH, PhD
Dr. Bruce is a Professor of Sociology in Psychiatry at Weill Medical College of Cornell University.

“When I was invited to join the Foundation Board, I already knew a lot about the Foundation’s mission and activities because of its growing presence at the annual meetings of the American Association for Geriatric Psychiatry. It was a natural progression for me to become involved.

“I’m a researcher, but it’s important to me to be able to help people in a direct way as well as with my work. The Foundation works with older people and their families in the areas of education and improving services—it provides a forum for interaction with older people. I like knowing that my work with the Foundation contributes directly to the well-being of older adults and their families.

“Aside from the simple challenge of being able to afford care, the biggest challenge facing older adults needing mental health care and their families is probably the combination of ageism and stigma that remains in our society. Even as society becomes more accepting of mental illness as a real illness, we still have to deal with the impact of ageism. Ageism leads to the belief that it is normal—inevitable—that people will suffer from depression, dementia, and other mental illnesses as they age. It is an ongoing challenge to change societal attitudes towards older adults, especially to generate support for the rights of older adults to good mental health and access to services. Education and empowerment are the keys to this issue.

“The solution is multifaceted. In part the solution rests in political activism, that is, giving consumer groups the opportunity to air their issues like the Foundation did in 2005 at the consumer forum in San Diego. Finding a solution also involves increasing the research base. Research provides the evidence that it is possible to reduce the risk of mental health problems for older adults, to increase their access to care when needed, and to provide high-quality mental health services with the expectation of positive outcomes. As a society, we must have the political and social will to pursue these changes.”