Is being old a mental health problem?

8 October 2013

 

What a stupid question. Of course it isn’t. Or is it? It seems to me that there is still a strong tendency among many people to associate old age very negatively, with a sense of it being a ‘burden on society’, something to be feared, and consisting primarily of an unpleasant combination of health conditions and problems – dementia and depression to name but two. And given that many people still use the phrase “mental health” to refer to mental illness there would appear to be a real risk that the association between old age and poor mental health is reinforced. So making older people the theme for this year’s World Mental Health Day does run the risk of reinforcing ageism and negative stereotypes about older people, and pathologising later life into a form of illness.

As the statistic above points out, most older people have fairly good mental health, but that’s not entirely due to the luck of the draw – we know that an adequate income, being treated with respect, having reasonable physical health, positive social relationships and having something to do are all protective factors for good mental health and reduce the risk of depression or dementia developing. A combination of collective and individual action that focuses on these factors, with particular attention paid to the most socially marginalised older people, is what is needed.

It was interesting to see that the UK came out as the 13th best country in the world to grow old in, as part of a study published on older people's day by Global AgeWatch Index. Using a range of factors to measure quality of life for older people, perhaps predictably, the top of the list was dominated by northern European countries (Sweden was number one). What was somewhat surprising was that countries, like Spain and Italy, where a healthy diet and family inclusion is often more positively attributed to growing old, were listed well below the UK at 22nd and 27th respectively, and Ireland was one place above us – something to do with “When Irish eyes are smiling?”

The relationship between mental health and age is a complex one and will vary from one individual to another, and certainly within generations. Many people with conditions such as dementia can still live well, remain active and contribute to their communities and society more widely. The so-called ‘baby boomers’ who are growing older include significant numbers who have potential ‘care capital’ – material, social, vocational and psychological resources, as well as a positive outlook – which could potentially be used to address mental health challenges as they age. And even the phrase ‘older people’ is becoming less meaningful if one compares the life experience, outlook and factors affecting the mental health of people who are currently in their 60s with those in their 80s and 90s.

Let’s start a better conversation about mental health and later life, recognising that for demographic reasons it’s an important one to have but also an opportunity to be more celebratory about older people and what they continue to offer society. While diagnosing a “severe case of old age” might generate more money for pharmaceutical companies if they are developing a drug that reverses the ageing process, personally I would prefer a collective prescription for society, to pay greater attention to the factors that support all to grow old in mental healthy ways.