Barriers to Eliminating Stigma

Roundtable participants identified the following barriers to eliminating stigma associated with older adults with mental health problems.

Lack of Information

Many older adults and their families lack knowledge about the causes and the impact of mental illnesses among older adults. They may not understand that mental illnesses are not “normal” to the aging process, and that recovery is possible. Lack of education about mental illnesses may perpetuate myths and shame about mental illnesses. Lack of knowledge about services that can effectively address the needs of older adults and their families who are affected by mental illness leaves many without solutions to their problems.

Lack of Resources

Projections are that there will be fewer geriatric health care professionals in the future, just as the demand for services rises. Little funding and attention is given to mental health care for older adults and for research.

“If you are on social security like I am, which is a limited income, and you suddenly discover that the doctors won’t take you because they don’t take Medicare anymore. You can’t get Medicaid because you make a little bit too much. And the public state mental health agencies can’t take you because they’re no longer taking Medicare patients. So you’re out there, you’re 68 years old, and you’re fighting everyday to get good mental health care.”

—Faye Brindell, Older Adult Consumer Mental Health Alliance

“Three percent or less of the Medicare budget is spent on psychiatric mental health care. Until we start talking about parity for mental health treatment in Medicare, and do something to make it happen, all of our talk is going to be about talk and it’s not going to change attitudes and change behavior.”

—Laurie Young, Executive Director, Older Women’s League

Lack of Competent Health Care Professionals

Health care professionals, such as doctors, nurses, physician’s assistants, and others, may discriminate against and stigmatize older adults with mental illnesses. These professionals may refuse to take these illnesses seriously, dismiss their patients’ complaints, or provide misdiagnoses or incomplete care.

Lack of Understanding

Organizations that provide services to older persons may be unaware of the signs and impact of mental illnesses among older adults. Even if a person’s disorder is recognized, those in an organization, a workplace, or a faith-based organization may assume that the problem is “understandable” or “normal” for an older person, or negatively judge that person because of the illness.

Lack of Interest

Few clearly valued roles for older adults exist in today’s society. Some people may view older persons as expendable, or as persons who use up critical resources. Social policy and programs are needed to support the ability of older adults with mental illnesses to pursue desired goals of working part-time, or serving as mentors, teachers, volunteers, or advocates.

“Until we make an impact on the general population, we’re not going to have an impact on stigma.”

—Larry W. Dupree, Chair, Department of Aging and Mental Health

Florida Mental Health Institute

The Challenge of Territoriality

Agencies and organizations working to help older adults may worry about their own agency self-preservation instead of focusing on the work of stopping stigma and discrimination, some participants said.

“I hope we will be able to make some diffcult decisions. We are all in our own little agencies, academic centers, facilities, looking for resources to support our own programs, fighting for those, sometimes becoming very territorial. I have great confidence that we can break out of that, make some decisions and be committed to serving the older adult with mental illness, foremost, above and beyond, our own institutional needs.”

—Eve Byrd, Fuqua Center for Late Life Depression