Experiences of ageism and the mental health of older adults

Lyons, Anthony; Alba, Beatrice; Heywood, Wendy; Fileborn, Bianca; Minichiello, Victor; Barrett, Catherine; Hinchliff, Sharron; Malta, Sue; Dow, Briony

doi:10.1080/13607863.2017.1364347

Cited by 125 publications

(88 citation statements)

References 40 publications

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“…Yet ageism among healthcare practitioners is an encountered problem that has shown to have a significant negative impact on mental health outcomes in older patients. [29][30] Older participants expressed feeling unheard, and their self-harm and overall mental health was not considered in the consultation room.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Role of primary care in supporting older adults who self-harm: a qualitative study in England

et al. 2019

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BackgroundSelf-harm and suicide are major public health concerns. Self-harm is the strongest risk factor for suicide, with the highest suicide rates reported in older populations. Little is known about how older adults access care following self-harm, but they are in frequent contact with primary care.AimTo identify and explore barriers and facilitators to accessing care within primary care for older adults who self-harm.Design and settingAn exploratory qualitative methods study using semi-structured interviews with older adults and third-sector workers in England. Older adults were invited to participate in one follow-up interview.MethodInterviews occurred between September 2017 and September 2018. These were audio-recorded, transcribed verbatim, and data analysed thematically. A patient and public involvement and engagement group contributed to the study design, data analysis, and interpretation.ResultsA total of 24 interviews with nine older adults and seven support workers, including eight follow-up interviews with older adults, were conducted. Three themes emerged: help-seeking decision factors; sources of support; and barriers and facilitators to accessing primary care.ConclusionDespite older adults’ frequent contact with GPs, barriers to primary care existed, which included stigma, previous negative experiences, and practical barriers such as mobility restrictions. Older adults’ help-seeking behaviour was facilitated by previous positive experiences. Primary care is a potential avenue for delivering effective self-harm support, management, and suicide prevention in older adults. Given the complex nature of self-harm, there is a need for primary care to work with other sectors to provide comprehensive support to older adults who self-harm.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Role of primary care in supporting older adults who self-harm: a qualitative study in England

et al. 2019

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“… 2 6 For example, recent Australian and US research shows experiences of ageism are strongly related to poor mental health in the later life course. 7–9 …”

Section: Introductionmentioning

confidence: 99%

Is disability exclusion associated with psychological distress? Australian evidence from a national cross-sectional survey

Temple

Kelaher

2018

BMJ Open

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ObjectiveTo examine the association between disability exclusion and psychological distress.DesignCross-sectional study.SettingPopulation-based study of individuals living in households across Australia.ParticipantsRespondents were persons aged 15 and over living with a disability.Primary outcome measuresReporting an experience of discrimination or avoidance behaviour due to a respondent’s disability. High or very high levels of psychological distress measured using the Kessler K10 instrument.MethodologyUsing the Survey of Disability, Ageing and Carers, we calculated the prevalence of persons with a disability experiencing psychological distress, disaggregated by experiences of disability exclusion, including discrimination and avoidance. Logistic regression models were fitted to examine the association between disability exclusion and psychological distress, once extensive controls and adjustments for survey design and presence of psychosocial disabilities were considered.ResultsAbout 62% of persons citing an experience of disability discrimination were in psychological distress, compared with 27% of those citing no discrimination. Furthermore, 53% of those who actively avoided social, familial or economic activities because of their disability experienced psychological distress, compared with 19% of those who did not avoid these situations. After controlling for demographic characteristics and disabling conditions, reporting an experience of disability discrimination or disability avoidance increased the odds of psychological distress by 2.2 (95% CI 1.74 to 2.26) and 2.6 (95% CI 2.28 to 2.97) times, respectively. Those who experienced both avoidance and discrimination were 3.7 (95% CI 2.95 to 4.72) times more likely to be in psychological distress than those experiencing neither. Avoidance and discrimination in healthcare settings were also found to be strongly associated with experiencing psychological distress.ConclusionsGiven new policy initiatives to improve disability care, coupled with the increasing speed of population ageing, the onus is on governments and its citizenry to address disability exclusion to offset potential mental health impacts.

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“…While this is laudable, one aspect of the exclusion of this group that has garnered less attention is how experiences of discrimination or avoidance of health care and other settings due to disability, is associated with health and wellbeing. This is despite considerable agreement in the literature that exposure to discrimination in its many guises is an important social determinant of health, with studies underscoring the implications for deleterious mental health outcomes (Kessler et al, 1999;Lyons et al, 2017;Paradies et al, 2015).…”

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confidence: 99%

Disability discrimination and avoidance in later life: prevalence, disability differentials and association with mental health

Temple

Kelaher

Williams

2018

Int. Psychogeriatr.

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Background:Later life is a period of increased risk of disability, but there is little quantitative evidence regarding the exclusion of older people (through discrimination and avoidance) due to their health conditions. This study aims to (1) measure the prevalence of disability exclusion in later life, (2) examine how experiences of exclusion differ by disability type, and (3) investigate the association of exposure to exclusion with psychological distress.Methods:Using data from the 2015 ABS Survey of Disability, Ageing and Carers, we calculated the prevalence of people aged 55 years and over with a disability experiencing discrimination and engaging in avoidance behaviors, disaggregated by 18 detailed disability types. Modified Log-Poisson models were fitted to estimate Prevalence Ratios to measure the association between exclusion and psychological distress, stratified by disability type.Results:In 2015, about 5% of Australians aged 55 years and over with a disability reported experiencing an instance of disability discrimination, and one in four reported avoiding a situation or context due to their disability. Accounting for psychosocial comorbidities and with extensive demographic controls, exposure to disability avoidance (PR = 1.9, 95% CI 1.7, 2.1) or discrimination (PR = 1.7, 95% CI 1.4, 2.1) almost doubled the probability of experiencing psychological distress. Effects were heightened for individuals reporting specific disabilities including sensory and speech and physical disabilities as well as those reporting a head injury, stroke, or acquired brain injury.Conclusions:Despite protections against disability discrimination in legislation, discrimination and avoidance due to disability is prevalent and is associated with poor mental health outcomes.

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Experiences of ageism and the mental health of older adults

Cited by 125 publications

References 40 publications

Role of primary care in supporting older adults who self-harm: a qualitative study in England

Role of primary care in supporting older adults who self-harm: a qualitative study in England

Is disability exclusion associated with psychological distress? Australian evidence from a national cross-sectional survey

Disability discrimination and avoidance in later life: prevalence, disability differentials and association with mental health

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