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Mental Health Awareness Month, 2024 (Week 1)

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Every May (Mental Health Awareness Month) our teams work diligently to stop the stigma and raise awareness of mental illness, and mental health treatments. You might be surprised to learn that 22.8% of US adults have a mental illness. That is almost one out of every four persons. The data for adolescents is even more staggering. 49% of children aged 13 to 18 have a mental illness. These numbers highlight the incredible need for our services across all age groups.

Let’s look at the prevalence of mental illness in America (according to the National Institute of Mental Health https://www.nimh.nih.gov/health/statistics/mental-illness#part_2538):

Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment.

Prevalence of AMI:

  • In 2021, there were an estimated 57.8 million adults aged 18 or older in the United States with AMI. This number represented 22.8% of all U.S. adults.
  • The prevalence of AMI was higher among females (27.2%) than males (18.1%).
  • Young adults aged 18-25 years had the highest prevalence of AMI (33.7%) compared to adults aged 26-49 years (28.1%) and aged 50 and older (15.0%).
  • The prevalence of AMI was highest among the adults reporting two or more races (34.9%), followed by American Indian / Alaskan Native (AI/AN) adults (26.6%). The prevalence of AMI was lowest among Asian adults (16.4%).
  • An estimated 49.5% of adolescents had any mental disorder.

Mental Health Services – AMI:

  • In 2021, among the 57.8 million adults with AMI, 26.5 million (47.2%) received mental health services in the past year.
  • More females with AMI (51.7%) received mental health services than males with AMI (40.0%).
  • The percentage of young adults aged 18-25 years with AMI who received mental health services (44.6%) was lower than adults with AMI aged 26-49 years (48.1%) and aged 50 and older (47.4%).
  • Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.

Severe mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.

Prevalence of SMI:

  • In 2021, there were an estimated 14.1 million adults aged 18 or older in the United States with SMI. This number represented 5.5% of all U.S. adults.
  • The prevalence of SMI was higher among females (7.0%) than males (4.0%).
  • Young adults aged 18-25 years had the highest prevalence of SMI (11.4%) compared to adults aged 26-49 years (7.1%) and aged 50 and older (2.5%).
  • The prevalence of SMI was highest among AI/AN adults (9.3%), followed by adults reporting two or more races (8.2%). The prevalence of SMI was lowest among Asian adults (2.8%).
  • Of adolescents with any mental disorder, an estimated 22.2% had severe impairment and/or distress. DSM-IV based criteria were used to determine severity level.

Mental Health Services – SMI:

  • In 2021, among the 14.1 million adults with SMI, 9.1 million (65.4%) received mental health treatment in the past year.
  • More females with SMI (67.6%) received mental health treatment than males with SMI (61.3%).
  • The percentage of young adults aged 18-25 years with SMI who received mental health treatment (57.9%) was lower than adults with SMI aged 26-49 years (67.0%) and aged 50 and older (71.0%).

These sobering statistics point out the work still to be done. Let’s use this month to spread awareness and attempt to reduce the stigma surrounding mental illness. Learn more about how Psychiatric Medical Care is improving access to mental health treatment. Our Senior Life Solutions program is a hospital-based intensive outpatient program that helps older adults who are experiencing anxiety, depression and other mental health challenges. Integrated Telehealth Partners provides flexible, cost-effective solutions to hospitals, health systems and jails to ensure patients recieve behavioral health services in a timely manner. Embrace Health offers teletherapy and telepsychiatry services and our new adolescent mental health clinic in Tennessee, Embrace U, provides intensive outpatient therapy programs to children and teens who are experiencing symptoms of a mental health condition.

Addressing the Need for Mental Healthcare in Rural Areas

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  • 6.5 million individuals living in rural areas have a mental illness
  • Over 60% of rural Americans live in designated mental health provider shortage areas

The Journal of Clinical and Translational Science published an article discussing the disparity between adults living in metropolitan and rural areas regarding access to and treatment of mental health conditions. While it was found that the prevalence of mental health was similar, it was determined that rural residents are less likely to receive timely and appropriate treatment for mental health issues. The reasons for this gap in care and treatment are two-fold. Rural residents are at a disadvantage from a location and cultural standpoint in some cases. These factors, including the non-existence of specialized providers in more rural areas, create a barrier for people needing mental health services. Because of their geographical location, rural residents have limited access to providers in proximity. There may be no mental health care nearby requiring them to drive to an urban area for treatment. Residents might also be unable to find trained mental health providers to help them or coordinate care with their physicians. Any available mental health services might be underutilized because of difficulty in finding care or the burden of traveling to receive care. Culturally, research has found that residents in rural areas seek out mental health care at a lower rate than their urban counterparts. Rural residents suffering from mental health issues might avoid seeking help because of the perceived stigma surrounding mental illness or a lack of education about mental health treatment.

According to the Rural Health Information Hub, rural residents might avoid seeking care because of a lack of anonymity in a smaller town or a lack of culturally appropriate care for minority patients. If these issues were addressed with access to care, rural residents would feel more comfortable seeking help from their local hospital. Overall, the need is clear for better access to mental health care for rural populations. However, several populations carry statistics that make the need significant if not urgent.

Special Populations at High Risk for Mental Health Issues

Demographic research has discovered that adolescents and older adults in rural areas are both at higher risk for mental health issues and death by suicide. Mental disorders are more prevalent in rural children than children in urban areas. Older adults in rural areas are also at a disadvantage. With a lack of specialty geriatric mental health care, 10-25% of the geriatric population diagnosed with serious mental illness go without care or treatment. Suicide risk is a particular concern for these two populations. With a suicide rate almost double that of urban areas, rural youth deaths by suicide are four times that of adults older than 34 years. Older adults in rural areas are also at significant risk. Social isolation, lack of financial means, and access to lethal means are some of the contributing factors to the high rates, but the common factor is the lack of mental health care services.

Mental Health Providers in Rural Areas

The absence of mental health care providers in rural areas is a significant concern based on the above statistics. Without access to mental health services, rural Americans are at an elevated risk of ongoing mental health issues. According to The Journal of Clinical and Translational Science, mental health provider shortage areas are home to over 60% of people in rural areas. This comes as no surprise when 65% of rural counties are without psychiatrists. Psychiatric Medical Care partners with rural hospitals to provide much-needed mental health services and care to patients in need.

Your hospital can benefit from Psychiatric Medical Care’s (PMC) comprehensive solutions:

  • After-care programs post-discharge
  • Award-winning community education support
  • Compliance and crisis prevention training
  • Financial impact and cost report analysis
  • Forms and billing training
  • Partnerships with medical schools
  • Physician and staff recruitment
  • Policies and procedures templates
  • Program management and operational oversight
  • Telepsychiatry system and capability

PMC’s programs are designed to meet the specific needs of acute care hospitals based in rural areas. We partner with small and large, for-profit and non-profit, critical access hospitals. Together, we can address your community’s needs and improve your older adults’ quality of life while providing a financial benefit to your hospital.

Download

Download a copy of this white paper – Addressing the Need for Mental Healthcare in Rural Areas.

About PMC

Psychiatric Medical Care (PMC) works to improve access to behavioral healthcare in communities like yours. Our founder and chief medical officer, James A. Greene, M.D., developed PMC with the sole mission of improving the function and quality of life for patients living in underserved communities. Our clinical leadership team consists of some of the country’s most knowledgeable and recognized mental health leaders. We offer extensive support to our hospitals and partners, including recruiting, training, and education for each clinical function. If you are interested in learning more about PMC and how your hospital could benefit from our partnership, contact us today.
Call (615) 647-0750 or visit our Contact Us page.

Understanding the Complex Issue of Suicide Among Older Adults

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Suicide is a deeply concerning and complex issue that affects individuals of all ages, backgrounds, and walks of life. While it’s often associated with younger individuals, it’s essential to recognize that older adults are also at risk. In fact, older adults may face unique challenges that make them more vulnerable to suicidal thoughts and actions. While older adults (65+) make up about 12% of the U.S. population they account for around 18% of suicides, according to the National Council on Aging.
Older adults often plan suicide more carefully than younger people, and use more lethal methods. One in four seniors who attempt suicide will succeed, compared to one in 200 youth.

Why are suicide rates higher in older adults?

Several age-related factors appear to contribute to higher rates of suicide in older adults. Among these, loneliness emerges as a primary catalyst. Many older adults find themselves living alone, often due to the loss of a spouse or the absence of nearby family and friends, resulting in a profound sense of isolation.

Additionally, several other factors contribute to suicidal intent in older adults:

Loss of Self-Sufficiency: Seniors who once led active lives, dressing themselves, driving, and enjoying various activities, may grapple with a profound loss of identity. They mourn the independent and vibrant person they once were.

Grief: As individuals age, they inevitably face the passing of beloved family members and friends due to aging and illness. Confronting their own mortality can trigger anxiety about death. For some, this “age of loss” becomes overwhelming, intensifying feelings of loneliness and despair.

Physical Health Issues: Older adults are more susceptible to illnesses and chronic conditions like arthritis, heart problems, high blood pressure, and diabetes. These health issues often bring about pain and mobility limitations that erode their quality of life. Sensory losses, such as diminished vision and hearing, further complicate their ability to engage in the activities they once enjoyed.

Access to Lethal Means: Older adults often have greater access to lethal means, such as prescription medications or firearms, which increases the potential for fatal suicide attempts.

Lack of Social Support: Limited social support networks make it challenging for older adults to reach out when in crisis.

Cognitive Impairment: Recent research in 2021 indicated that older adults with mild cognitive impairment and dementia face a higher suicide risk. The decline in cognitive function can affect decision-making abilities and increase impulsivity, intensifying emotional struggles.

Financial Issues: Many older adults rely on fixed incomes, making it challenging to cover basic expenses. As we age, we tend to take on more healthcare expenses, which can be costly. Financial stress, particularly for those already dealing with health problems or grief, can act as a catalyst for suicidal thoughts.

The cognitive, emotional, and physical challenges and lack of mental health support that older adults encounter can lead to the development of depression. This mood disorder is characterized by persistent feelings of sadness, hopelessness, and a loss of interest in once-enjoyed activities. While most individuals with clinical depression do not attempt suicide, it does elevate the risk. Recognizing these complex factors is essential for fostering a better understanding of and response to suicidal behavior among older adults.

Alarming Statistics About Older Adult Suicide

Recent data reveals alarming statistics regarding suicide rates among older adults, particularly those aged 75 and older.

Adults aged 75 and older have one of the highest suicide rates, with 20.3 suicides per 100,000 individuals.

Men aged 75 and older face an even higher risk, with a rate of 42.2 suicides per 100,000 individuals, surpassing other age groups.

Non-Hispanic white men in this age group experience the highest suicide rate, reaching 50.1 suicides per 100,000 individuals.

Source: Centers for Disease Control

Identifying Suicidal Thoughts in Older Adults

Recognizing signs of suicidal thoughts is crucial for the well-being of older adults. Suicidal thoughts are often linked to depression and should always be taken seriously. There are two categories of these thoughts:

Passive Suicidal Thoughts: These thoughts include feeling “better off dead” and, while not always indicative of immediate risk, signify significant distress that requires prompt attention.

Active Suicidal Thoughts: These thoughts involve contemplating actions to harm or kill oneself, often indicated by a “yes” response to questions like, “Have you had any thoughts of hurting or killing yourself in the last two weeks?” These thoughts demand immediate clinical assessment and intervention by a mental health professional.

Warning signs of suicide include:

  • Avoiding social functions
  • Self-neglect, lack of grooming
  • Preoccupation with death
  • Declined interest in activities they once enjoyed
  • No concern for personal safety
  • Changing their will or giving beloved items away

How to Help a Suicidal Older Adult

If someone you know expresses active suicidal thoughts or has a suicide plan with intent to act, it is crucial to take immediate action. Don’t be afraid to ask them direct questions like, “Are you thinking about suicide?” Tell them you want to help and be sure to listen to what they have to say.

Stay with Them: Do not leave the individual alone, as your presence provides immediate support and ensures their safety.

Seek Professional Help: Contact emergency services or a mental health professional promptly. Suicidal ideation is a severe mental health concern that requires expert intervention. Call 988, the new Suicide and Crisis Lifeline, which offers counselors and confidential support 24 hours a day.

Reconnect with Them: Studies show that checking in with a person who experienced suicidal thoughts can decrease their risk of suicide. Even a phone call, text message or letter can help.

The high suicide rates among older adults, particularly those aged 75 and older, highlight the urgent need to address this pressing issue. Age is not a safeguard against mental health challenges, and understanding the signs, raising awareness, and providing support and resources are essential steps toward preventing suicide among older adults. By working together, we can ensure that older adults receive the care and attention they deserve to preserve their mental and emotional well-being.