Public Health Perspectives of Geriatric Mental Health Care

Abstract

Background: In older adults (aged 60 years and above), mental health problems are gaining public health importance because of the increasing prevalence, disease burden, disability, morbidity, and mortality. Epidemiological studies on major mental health disorders such as depression and dementia in older adults have contributed to a better understanding of the distribution and determinants of these conditions. Identifying potential risk factors has stimulated interventional research on preventing these conditions under the public health framework towards their management. The increasing burden of geriatric mental health conditions like dementia in developing countries like India can contribute to significant challenges if there is no adequate strengthening of the public health response. This includes scaling up the measures of prevention, public awareness, early diagnosis, and quality health and social care equitably available to all sections of the population. The Decade of Healthy Ageing (2021–2030) provides the opportunity for concerted and coordinated initiatives to improve intrinsic capacity (physical and mental) and offer an age-friendly environment to enhance the functional ability of all older adults. Methods: This article reviews the critical public health issues related to geriatric mental health in India.

Primary mental healthcare for older people in India: between stigmatization and community orientation

“…In a study by Scazufca et al [ 72 ] from Brazil, low-intensity psychosocial and psychoeducation interventions delivered and led by CHWs partly in the homes of older persons were shown to be effective in recovery from old-age depression and in the reduction of barriers to care. Similar results and care models have also been shown to be effective in India [ 73 – 75 ] and are promoted to effectively improve care for mental health conditions in old age [ 76 ]. However, according to the results of our study, transforming the scope of practice of CHWs in India to include mental healthcare for older persons is a major challenge.…”

“…Considering the influence of local contexts [ 76 , 80 ], we can assume regional variations in social norms and perceptions of mental health and old age on a community level. Further research could examine the heterogeneity of Indian regions.…”

Clinical practice guidelines for promoting mental health and well-being of older adults: A special focus on strategies for coping with social isolation and loneliness

“…A task-sharing approach by training other stakeholders, including lay people involved in the care of older adults, is an important strategy to address the shortage of specialized workforce. [ 1 ] Collaborative care interventions using the task-sharing approach have been implemented in primary care for the management and prevention of depression, suicide risk, etc. [ 8 ] The task-sharing approach is essential for scaling up the interventions for promoting mental health and well-being in older adults.…”

“…Mental health care in older adults requires a public health approach with a focus on promoting the mental health and well-being through a comprehensive and multi-sectoral intervention. [ 1 ] Mental health problems in older adults have several biological and psychosocial determinants, including important factors, such as social isolation and loneliness. [ 2 ]…”

Dementia in India: An Overview

“…Currently, it is estimated that there are around 4 million people living with dementia in India, and this number is projected to rise to nearly 14 million by 2050 (Gulia & Kumar, 2018;Lahiri et al, 2019;Smith et al, 2021;Vancampfort et al, 2019). The high burden of dementia in India is due to a combination of factors, including demographic changes, lifestyle factors, and the increasing prevalence of risk factors such as hypertension, diabetes, and depression (Malapur et al, 2021;Rangarajan et al, 2021). However, it is important to note that dementia is often underdiagnosed and underreported in India, so the true prevalence of the disease may be higher than what is currently estimated (Bateman et al, 2016;Kandiah et al, 2021).…”