Message from the President – John D. Piacitelli

“OLDER PERSONS AND OTHER ADULTS”

Does the phrase:  “Older persons and other adults” look strange to you? Well it does to me too. That is, “strange” in the sense of  “unfamiliar”. “Unfamiliar” because such a term is seldom, if ever used. That’s fine by me, but what is not so fine is the fact that federal and state mental health planners, administrators, and data collectors just as infrequently differentiate between  “adults and older persons”

People seem to be quite comfortable saying “Children and adults”, and well they should be. There are significant differences between children and adults in terms of needs, abilities, problems, dependency, etc.  Therefore, they should be addressed separately in regard to services and programs that address these differences.

Why then is it so terribly difficult for these same people to recognize the importance of acknowledging the differences that exist between the older persons and the younger adult population when it comes to planning, funding and delivery of mental health services.

I must not be the only person that wonders about this. Recently I received the following from a member of OACMHA: “ I have read the New Freedom report.  Nowhere does it deal directly with old adult mental health issues.  "Across the life span" and "all ages" are only mentioned in passing in the discussion.  In looking over the membership of the group and their affiliations, there appears to be no representation of the interests of older folks.  I don't know what can be done about this omission, but surely the Senate Committee on Aging should be alerted. My experience with these commissions is that when their report is published, their work is done.  If not, should not there be presented to them the need for a supplemental document? And an offer to assist?”

I was asked by another member why it was that in the in the report she read about the   SAMSHA/NASMHPD sponsored Conference on the subject of “Eliminating the Use of Seclusion and Restraint”.  She found not one mention of the fact that older people are   especially subject to the use of both seclusion and restraint in the mental health and the long-term care settings. This being the case, do they not present a significant enough of a problem that they merit special attention at such a conference. If not, how are they ever going to be free from the effects of both seclusion and the use of restrain?

As a matter of fact I attended this conference and indeed   the reason nothing was said in the report specific to older adults was that no conference time was allotted to discussion of how daily across the nation older people are being subjected to the use (abuse) of both restraints and seclusion in their inpatient and long-term care settings.  After all, an adult is an adult is an adult, so why give any special attention to the “older adult”. After all they are just another “adult”! Apparently, this is their reasoning despite the fact that the types of restraints and seclusion generally are different from those used on younger adults. But more importantly they ignore the fact that the effects of their use on older persons’ health and welfare are even more devastating.

So from these contacts from other members, I am encouraged by the realization that indeed there are people out there that feel older persons are not “just another adult” and that because they are not, they require recognition of this fact by all persons responsible for state and federal mental health services.  Once this recognition is given, I can assure you that the number of older persons being served by mental health providers will get to the point that they are served at least in proportion to the percentage they represent in the total population and will be provided with services that are tailored to their special and unique needs. 

An After-thought – By  The President - John D. Piacitelli

You probably all can remember the news coverage that was given during the summer to the tragic incident in which an 86 year-old man drove his car into a farmer’s market in California, killing ten and injuring dozens.   Indeed this was a terrible tragedy and certainly was deserving of attention on the part of the press.

Unfortunately, it also led to general criticism of elderly drivers. I do not intend to go into the merits of this criticism – except to say that it might well have been accompanied by criticism of public transportation systems for their failure to provide adequate transportation opportunities for older persons as an alternative to their driving cars.

However, what really concerns me is the fact that this same press chooses not to give much attention to suicides committed by older persons.

The deaths and injuries suffered in this tragic accident were truly regrettable. But, is not the fact that the attempted suicide and successful suicide rate in the older population is by far the highest of  that in any other age group also regrettable and deserving of being reported in the press.?   According to the National Institute of Mental Health,  older Americans are disproportionately likely to die by suicide.  Comprising only 13 percent of the U.S. population, individuals age 65 and older accounted for 18 percent of all suicide deaths in 2000.  Among the highest rates (when categorized by gender and race) were white men age 85 and older: 59 deaths per 100,000 persons in 2000, more than five times the national U.S. rate of 10.6 per 100,000

In the US, someone age 65 or over commits suicide every 90 minutes -- 16 deaths a day.  It is also estimated that suicide by older adults may be under-reported by as much as 40% or more. These statistics do not include what some also see as suicide, deaths from medical noncompliance and overdoses, self-starvation or dehydration, and "accidents." Older adults have a higher rate of suicide success because they use methods such as hanging, drowning or self-inflicted gunshots.

Accidental death and self-inflicted death are both actually preventable. So let the press raise question about licensing rules that permit older persons to drive and be a potential threat to other people’s lives. But at the same time it would seem reasonable that this same press raise questions about the causes of such high rates of suicide by older persons and to suggest that suicide prevention programs should begin to focus their attention on the older population in an effort to save the lives of older persons.  Just a thought!