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Elder mental health still a concern

An elderly Indian man at the retirement home. Illustration of mental health conditions among senior citizens. Image credit: rawpixel / 123rf. Concept of elder abuse, neglect, and loneliness. Elder mental health concept.
The COVID-19 outbreak has led to an increase in mental health conditions being reported, with concern for vulnerable populations such as senior citizens. Image credit: rawpixel / 123rf

We still need to be concerned about elder mental health, Dr Reema Nadig argues in an article for – especially in the context of the pandemic. 

Dr Nadig, chief operating officer and group medical director  of KITES Senior Care, highlights that mental health issues affect twenty percent of India’s seniors according to the Longitudinal Ageing Study. The COVID-19 pandemic has only exacerbated the mental health of our elderly citizens, Nadig asserts, writing “many elders suffer from pre-existing medical conditions or comorbidities. The rapid surge in COVID cases, fear of contracting the virus, restricted movement and socialising has instilled a sense of uncertainty among the elderly. 

“They are unable to freely move around even for basic chores, and in some cases – unable to meet their children and other family members. Besides the threat of contracting coronavirus infection, social isolation itself could be a source of anxiety and other psychological problems. If infected by COVID-19, the self-isolation (in mild cases) or recovery in the hospital is a traumatic experience.”

Elderly mental health has long been a concern in India, as Health Issues India has previously reported. In 2018, we cited a survey of 1,000 elderly Indians across seven states conducted by IVH Senior Care, an elder care provider headquartered in Noida, Uttar Pradesh, which pointed towards mental health as cause for concern among our seniors. “Just one tenth of India’s seniors are not concerned about loneliness. 36 percent of those surveyed identified social interaction as their top priority in day-to-day life,” we wrote. “The survey reveals that just two percent of Indian seniors consider themselves to have a good quality of life. 71 percent of surveyees say their lives could be improved. The data suggests that social isolation is a major driving force behind this epidemic of low mood and marginalisation of one of society’s most vulnerable demographics.” As India’s ageing population grows, so too are mental health issues which already affect one in seven Indians. 

As a consequence of the pandemic and consequent draconian measures, social isolation has become the norm for most of us, if not all of us to some degree. For seniors, the consequences of being confined to their home may be even more severe – especially in the case of those who live alone. This is compounded by worrisome trends of elder abuse, which can occur in a range of forms. 

A recent report shone a light on the plight of India’s seniors during the pandemic and how the deficiencies in India’s medical infrastructure only serves to exacerbate their mental wellbeing woes. A survey of 3,526 across six major cities found that 50.8 percent of respondents would experience better mental wellbeing through improved medical and health infrastructure; 44.4 percent via better availability of vaccines; and 38.7 percent through timely availability of medicines and injections. Approximately 42.1 percent of the respondents expressed concern of hospitalisation if infected with COVID-19; 34.2 percent expressed apprehension about isolation; and 62.1 percent felt the risk of elder abuse increased during the pandemic. 

Rohit Prasad, chief executive officer of HelpAge India, said “what is heart-wrenching about this report is that the senior citizens have always been counted as the most vulnerable to COVID-19 when it comes to physical health but very little attention has been paid to their mental health. There is a very deep sense of worry and loneliness among them.”

The question is: what can be done? According to Dr Nadig, “a plethora of measures such as social facilitation interventions, psychological therapies, health and social care provision, befriending interventions and leisure skill development can be helpful in mitigating mental health consequences during isolation. Creating and promoting a sense of physical and social safety, hope, connectedness, calming and community efficacy have been found to be effective in controlling or mitigating the potential adverse effects of social isolation.”

In addition, she argues for reducing the levels of stigma associated with mental health conditions which, as Health Issues India has noted in the past, is considerable with prejudicial attitudes towards those affected by mental health issues harboured by a disturbing proportion of the Indian populace and ingrained within the country’s social order. Plugging the sizable treatment gap when it comes to mental healthcare is also a necessity. Veneration of our elders is often regarded as a staple of Indian culture. When it comes to preserving elder mental health, it is clear we are failing them. 

Contact details for mental health support in India can be accessed here. 

If you are suicidal or experiencing suicidal thoughts, visit your nearest hospital or contact AASRA on 91-22-27546669 or Sneha India on 91 44 24640050 helpline. A list of other suicide helplines can be accessed here.

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