The Canadian Coalition for Seniors Mental Health has as its mission to “promote the mental health of seniors by connecting people, ideas and resources.”
Kimberley Wilson, executive director of the CCSMH, sat down with The Globe and Mail's André Picard to discuss the state of seniors' mental health in Canada.
When the public thinks of brain disease in seniors, it is often dementia that comes to mind. Do seniors also suffer from depression, bipolar, schizophrenia and other psychiatric illnesses?
Kimberley Wilson: Yes, absolutely. We know that one in five Canadians experience a mental illness in their lifetime and this is no different for older adults. Some people age with an illness they've had their whole life, and others will experience the onset of symptoms for the first time in late life. Certainly seniors are not immune to the conditions that others in the population face.
They're not immune, but are they actually more likely to suffer from mental illness because they're old?
In some ways, yes, because some of the transitions that occur in later life put people at greater risk of mental illnesses. There are also some areas, like schizophrenia, where we don't have much research and literature because it's a new phenomenon and people are aging with it. So we're still learning a lot and we don't have all the numbers or all the answers.
Research shows that about 75 per cent of mental illnesses begin in childhood and adolescence, but can mental illness also strike for the first time in older adults?
Yes. Age can be a risk factor for some mental illnesses, such as dementia, which people associate with aging. But things like life transitions that can come typically in late life – such as retirement, loss of a partner, friends, family, and chronic medical conditions – can also increase a person's risk. Like I said before, no one is immune to mental illness at any time, but conditions like dementia increase in late life; depression is common later in life; and conditions like delirium – which we never talk about – are very common after someone older has surgery.
You're right, delirium isn't discussed much. What is it?
Delirium is an acute confused state that can be brought about after surgery like hip surgery, or by a urinary tract infection. The challenge for health professionals is to distinguish between dementia, depression and delirium. Delirium is a medical emergency and, if caught and treated, it can be totally cured but often it goes undiagnosed because there's an assumption that confusion is part of growing old.
There is a common perception out there that – stated crudely – goes something like this: “Of course seniors are depressed, they're sick, their friends are dying and so on.” Is it true that all seniors are depressed or doomed to depression?
Unfortunately that is a widespread belief. From my perspective, that's our biggest challenge. We need to get the message out that depression is not a typical consequence of aging. There are most certainly life transitions that are unique to this age group, and they present challenges. When someone loses a spouse, loses autonomy due to illness, moves out of the family home and into a care facility, it's normal to feel sad and grieve those losses. But depression is not a typical reaction to these life events – it goes well beyond the normal feelings of sadness and grief. People should not assume that if a person is depressed in late life that there is no hope.
So what you're saying is that most seniors in the community have a pretty good mental health status – they're happy and productive citizens?
