Older Adults’ Narratives of Seeking Mental Health Treatment: Making Sense of Mental Health Challenges and “Muddling Through” to Care

Abstract

Older adults who experience challenges related to mental health are unlikely to seek professional help. The voices of older adults who have navigated through mental health issues and systems of care to arrive at psychological treatment are less well understood. We conducted individual interviews with 15 adults aged 61 to 86 who sought psychological treatment. Interviews were audio-recorded, transcribed, and analyzed using narrative methods. We identified several main storylines that describe the meaning-making and treatment-seeking journeys of older adults: resistance to being labeled with mental health problems (telling stories of resistance, defining mental health issues in mysterious and uncontrollable terms, and experiencing internal role conflict); muddling through the help-seeking process (manifestations of chaos and system-level barriers); and emotional reactions to psychological treatment (hope, fear, and mistrust). Findings add to the literature base in the area of narrative gerontology, and highlight the complex experiences that older adults face when seeking psychological treatment.

A Theory on the Components of Depression Self-Management in Older Adults

“…Several internal (individual) and external factors contributed to the experience of the core problem. Consistent with the literature (Reynolds et al, 2020; Switzer et al, 2006), participants’ individual characteristics were evident in how they recognized and responded to a diagnosis of depression. This process reflected their personal history and individual capacity.…”

“…Prevailing systems of care frequently lead to the disempowerment of patients, rather than facilitating better engagement and health outcomes (McDonald, 2014). Consistent with other studies of older adults with depression (Reynolds et al, 2020;Switzer et al, 2006;Wittink et al, 2008), current participants sought to identify and implement adaptive coping strategies to improve their overall well-being and quality of life. The experiences of individuals in seeking a diagnosis, receiving treatment, and becoming experts in their own care should be used to inform strategies to support self-management at the practice level.…”

“…In the current context, this requires a shift from the biomedical discourse of depression in older age to a broader focus on supporting individuals to self-manage their depression. Qualitative research is ideal for this purpose (Doblyte & Jiménez-Mejías, 2017;Reynolds et al, 2020).…”

“…In addition to the significant impact of depression on individuals, increased prevalence in older adults has serious implications for health service planning and utilization (St-Hilaire et al, 2017; Wells et al, 2020). Integrated approaches are needed to manage a chronic illness like depression while enhancing well-being, to reduce demands on the health care system (Cramm & Nieboer, 2015; Ellis et al, 2017; Reynolds et al, 2020). Self-management is one such approach.…”

“I Will Not Be Defined by This. I’m Not Going to Live Like a Victim; It Is Not Going to Define My Life”: Exploring Breast Cancer Survivors’ Experiences and Sense of Self

“…The sharing of experiences in counseling and support groups provides an important source of consensual validation for BC survivors' feelings and ways of coping, which in turn can promote positive transformative change and growth. This study's findings may help health care professionals provide care for women with BC in that it highlights the process of identity reconstruction that some women undergo in the survivor journey and how this may impact on psychosocial well-being (Emslie et al, 2017;Reynolds et al, 2020). The telling of our survivor's experiences also contributes to further knowledge in embodying care physically, emotionally, and mentally for patients and survivors' support networks; to reduce distress and fear; and to facilitate a higher rate of survivorship (Ustjanauskas et al, 2017).…”