Adults over the age of 60 with mental health and/or substance use disorders are faced with challenges to live successfully in the community. They have complex issues disrupting their ability to interact with others resulting in undesirable behaviors. Older adults are supported by agencies, facilities and organizations in the community; however, many are unable to maintain these supports due to the staff lack of an understanding of mental health and/or substance use disorders.
Therefore, it is essential for the staff to have an understanding of mental health and substance use issues, possess the skills to prevent and diffuse crisis situations and have the ability and confidence to appropriately support older adults. Primary care physicians, emergency department staff, and EMS responders frequently provide services to older adults due to physical complaints or injuries.
However, the underlying cause for the physical complaint or injury may be due to an undetected mental health and/or substance use issue that may result in costly medical care and longer hospital stays.
Older adults, especially those with mental health or substance use disorders, are often victims of elder abuse. The district attorneys conducting interviews with older adults do not understand how to direct questions in a manner that promotes a sense of safety and willingness to discuss their experience. The interview is more challenging when the older person has a mental health or substance use issue.
According to Office of State Budget and Management 2013 Facts and Figures Report, 20% of adults were over the age of 60. It is estimated that this will increase to 25% in 2025 and 31% in 2032 due to aging “Baby Boomers”. It is projected that these older adults will live in the community with many having mental health and substance use issues. The NC Injury and Violence Prevention Branch tracks suicide through the Violent Death Reporting System which reports the highest number of suicide in NC per total population of the age group is males age 85 and older. It is crucial for people working in community facilities, agencies, and organizations providing services to older adults understand the behavioral health needs of older adults.
Depression is a true and treatable medical condition, not a normal part of aging. However older adults are at an increased risk for experiencing depression. The changes that often come in later life—retirement, the death of loved ones, increased isolation, medical problems—can lead to depression. Depression is not just having "the blues" or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension.
More about Older Adults and Depression
Substance use, particularly of alcohol and prescription drugs, among adults 60 and older is one of the fastest growing health problems facing the country. Yet, even as the number of older adults suffering from these disorders climbs, the situation remains underestimated, underidentified, underdiagnosed, and undertreated.
More about Older Adults and Substance Use Disorder
Older adults, especially white males, have a higher risk of completed suicides than any other population group worldwide. From 2009 to 2013, 1,204 North Carolina residents ages 65 and older died as a result of violence. Of these violent deaths, 993 were suicide (82.5%). The most common method used is firearms.
Veteran Affairs reports from 2013 – 2016 the highest number of Veterans are between ages 65 – 69. It is projected the highest number of Veterans from 2017 – 2021 will be between the ages of 70 – 74 and from 2022 and 2028 will be between the ages of 75 – 79. Many older Veterans find they have PTSD symptoms even 50 or more years after their wartime experience. Some symptoms of PTSD include having nightmares or feeling like you are reliving the event, avoiding situations that remind you of the event, being easily startled, and loss of interest in activities.
Geriatric Adult Mental Health Specialty Teams
The Geriatric Adult Mental Health Specialty Team (GAST) Program began in 2003 as a result of the closing of the Geriatric Units at the state psychiatric hospitals. Many older adults are living in the community in Long-term Care facilities and private homes. The teams provide training in mental health and substance use issues and support to people working with older adults living in the community. The GAST goal is to increase the community’s knowledge and understanding of the issues of mental health and substance use on older adults. Training has been provided in locations such as Long Term Care facilities, Senior Centers, Home Care Agencies, faith-based organizations and Departments of Social Services.
For questions, concerns or more information please email: Patricia McNear
- Division of Aging and Adult Services NC Aging Profile
- National Institute Mental Health Depression
- Social Work Today The Changing Face of Older Adult Substance Abuse – January/February 2012 Issue
- National Institute on Alcohol Abuse and Alcoholism Older Adults
National Institute Mental Health Depression
American Psychological Association Depression and Suicide in Older Adults Resource Guide
Psychiatric Times Substance Abuse in Aging and Elderly Adults
National Institute Health Senior Health
Social Work Today The Changing Face of Older Adult Substance Abuse – January/February 2012 Issue
National Institute on Alcohol Abuse and Alcoholism Older Adults
Substance Abuse Among Older Adults