Psychologists' role in the provision of mental health care for the elderly.

Abstract

Teachers Association -American Association of Retired Persons to do a survey of U.S. psychologists who offer mental health services. These psychologists were sent a 3-page questionnaire that requested information regarding attitudes toward, knowledge of, and practices with mature and older adults. The results of the survey indicate that although psychologists may have some stereotyped impressions of the aged, for the most part they have some basic knowledge about the aging process. The results also indicate that psychologists are interested in learning more about this area and are interested in seeking out aged clients so that adequate care may be provided.A continuing problem for gerontologists is that of determining the reasons why elderly adults do not make use of mental health care facilities, especially in light of the extent of their mental health problems. Surveys have shown that from 5% to 8% of community-based elderly show pathology severe enough to warrant hospitalization. If those exhibiting neuroses or personality disorders are included, the incidence of pathology may range from 12% to 22% (Lowenthal, Berkman, & Associates, 1967;Shanas, 1968). These statistics become increasingly important when it is recognized that older persons account for only 2% of those seen in psychiatric outpatient clinics (Maddox, 1966) and that those who seek private mental health care are estimated to be still fewer (Busse & Pfeiffer, 1969). Lowenthal (1964) and Busse and Pfeiffer (1969) have suggested several factors that may account for this underutilization of services. One of the hypotheses is that there are negative attitudes within the community of mental health professionals that interfere with the availability of services to the elderly. These attitudes may be apparent in expressed preferences for young clients or nonacceptance of elderly people as patients in mental health settings. This may occur because professionals feel a lack of training or personal experience with the problems of aging. Or there may be the belief that scarce resources of time, energy, and money should be expended on younger clients and not on those close to death, to whom long-term benefits would not be possible. Although there is some research that supports this hypothesis within other professional groups (Cyrus-Lutz & Gaitz, 1972;Ginsberg & Goldstein, 1974;Moberg, 1969), a survey of U.S. psychologists regarding their present level of involvement with the aged is lacking. The purpose of this article is to present such data and also information regarding the attitudes of psychologists toward seeking out the aged as clients. Further, because it was felt that individuals in the entire second half of life (past 40 years of age) may be neglected in terms of mental health care, information regarding attitudes toward mature (40-60-year-olds), as well as aged (60 years and over), individuals was obtained within the same survey.

The Influence of Client Age on Clinical Judgements of Male and Female Social Workers

“…In addition, marital and parental conflicts were also described. The symptom picture was kept relatively nonspecific since it has been shown that judgments of severity are more likely to be affected by age when there is not clear-cut severe pathology (Dye, 1978).…”

“…Empirical studies have reported age bias among psychologists and psychiatrists but not social workers. Clinical and counseling psychologists consistently preferred younger to older clients, regardless of diagnostic category (Dye, 1978;Wolk & Wolk, 1971: Wilensky & Barmack, 1966. In responding to case vignettes, clinical psychologists recommended more medication and less long-term psychotherapy for the older client than the younger client (Ray, McKinney & Ford, 1987;Rodin & Langer, 1980).…”

Ageism: Prejudice Against Our Feared Future Self

“…However, there is a lack of compelling evidence to support this speculation. Because of methodological problems and mixed evidence for ageism in psychological services to older people (e.g., Dye, 1978, found no ageism in diagnoses of depression), it is unclear whether there is a strong ageist bias among mental health professionals. Rather, it may be the case that therapists are more influenced by misconceptions about normal aging processes, and as such, ageist thinking can be addressed in clinical training with increased emphasis on understanding the normal and abnormal aspects of the aging process (Gatz & Pearson, 1988).…”

Ageism in Mental Health Assessment and Treatment of Older Adults

“…Nevertheless, a number of studies over the last three decades have demonstrated the existence of negative attitudes toward older adults among psychotherapists. For example, Dye (1978) found negative views regarding the ageing process, and a preference against working with older patients, in a large sample of clinical and counseling psychologists in the USA. Older persons were described by the psychologists as being rigid, as having difficulties in learning new material, and as lacking the required energy and resilience for therapeutic growth.…”