Roundtable Meeting on Seniors’ Mental Health – Highlights Report

Roundtable Highlights Report

Prepared May 13, 2010 by Ascentum

1. Participant Profile: Twenty six participants attended the roundtable, representing all regions of Canada. ‘Baby boomers’, those aged 45-64, made up the largest age group at 70.9%. Only 4.4% of participants were over 75, while 8.8% were 34 or younger. When asked about their primary perspective, the three largest groups were health and social service professionals (43% of participants), family members or friends (17%), and people living with mental health problems or illnesses (13%). Responding to a question about their secondary perspective, 38% self-identified as academics or researchers, 25% as family members or friends, and 17% as ‘others’, which included members of community organizations/NGOs, and concerned individuals.
2. Key Issues
   Summary of participants’ recommended actions and approaches in response to the key issues discussed:
   i. Designing mental health policy and services to include the unique mental health needs of seniors: Need more attention on training future caregivers (curricula); need greater clarity on where Dementia fits in the mental health strategy; address cultural Issues (language); embrace situational/transitional phases of life (e.g. loss, retirement); standards of care need to be clear; seniors’ lens to be applied to everything, to ensure that their needs are met.
   ii. Improving the capacity of the health care system to meet the complex cognitive, mental and physical health problems of seniors: Collaboration and continuity will lead to improved care; more holistic and integrated approaches to care needed; improved education in medical schools/colleges to deal with complex cognitive, mental and physical health problems; knowledge mobilization missing and needs to be integrated; supports and services unavailable in many communities (due to funding, culture, geographic, informational/knowledge); training has to work both ways (older people need to be trained to deal with home support workers from different cultures); broaden home care criteria to allow those with mental health problems/illnesses to access care; much stronger language on addictions needed.
   iii. Paying more attention to promotion, prevention and early intervention for seniors: Involve/respect family and patient in decision-making processes; make communities seniors-friendly (e.g. public transportation options, benches); greater collaboration and continuity of care needed between community services and physicians; address proximal factors that impact seniors (societal, environmental factors); link physical and mental health and prevention; spread knowledge that early interventions needed for depression; lack of assessment for mild cognitive impairment.
   iv. Addressing the particular concerns of family caregivers of seniors with mental health problems and illnesses: Engage patients, families and caregivers in care plans; develop a mental health act with an independent auditor; create a civilian watchdog position with real powers; challenges of trying to help individual who does not want help; do not assume that families will always be involved in all processes; importance of families monitoring / observing changes and informing doctors.
   v. Reducing the double stigma of mental illness and ageism: Fight stigma nationally, in all sectors (schools, police, government) through mass media campaign; educate and train people to overcome fear of doing the wrong thing (now they back off rather than being proactive); double stigma: older people grew up with prejudices about older people; ageism is huge.
   vi. Preparing for the next generation of seniors: Next generation will not have good incomes due to current economic crisis; unique situation of 2sLGBTQ+ community needs to be addressed; Baby Boomer panache for alternative medicine needs to be addressed; Diabetes and vascular issues may be more prevalent than dementia.
   vii. Other Issues: Be aware of the interconnectedness of the 18 themes; greater community emphasis; increase workforce capacity to deal with seniors; ensure financial resources for seniors are addressed (as one of the social determinants of health); address cultural/geographic issues; do more promotion/prevention when people have major health issues (develop a tool kit); suicide is underreported and overlooked amongst seniors / must be addressed. The first keypad exercise showed strong levels of support for the key issues identified by the Commission, with each issue being considered ‘important’ or ‘very important’ by over 90% of participants. “Improving the capacity of the health care system to meet the complex cognitive, mental and physical problems of seniors” received unanimous support – all thought it was very important. Likewise, all participants rated “designing mental health policy and services to include the unique mental health needs of seniors as ‘important’ or ‘very important’ (Figures 1.2, 1.1). While 96% of participants agreed that “reducing the double stigma of mental illness and ageism” was ‘important’, a smaller majority (57%) indicated it was ‘very important’ (Figure 1.5). Overall pre and post voting (before and after table and plenary discussions) on whether the issues identified captured what needs to be addressed to develop a strategic plan for seniors’ mental health revealed an increase in the percentage of those who ‘agreed’ or ‘strongly agreed,’ moving from 79% to 91% of participants. There was also a decline in the percentage of people who somewhat disagreed (Figure 1.7).