Silencing the Stigma

Last month, we discussed the social, institutional, and self-stigmatization of mental illness in the elderly and their ramifications. This week, we will discuss current efforts to eradicate mental health stigma and improve access to care.

How can we influence the media’s depiction seniors with mental illnesses?

notebook2004While the media promulgates inaccurate and damaging stereotypes about mental illness, it can also be a source of positive change in the battle against social stigma. For example, the movie The Notebook (2004) provides a genuine portrayal of strain and heart-ache accompanied by dementia. The vast majority of mass media, however, reinforce social stigma through stereotypical presentations of mental illness.

Organizations such as the Center for Mental Health and Media and Mental Health Reporting have launched their own campaigns to counter prevailing stereotypes by educating the public. They have also posted tips for reporters and screen writers to avoid promoting stigmas. Writers should:

  • Ask, “Is mental illness relevant to the story?”
  • Verify statements that mental illness is a factor in a violent crime. A past history of mental illness is not necessarily a reliable indicator.massmedia
  • Avoid using language that implies people with mental illness are violent.
  • Double-check specific symptoms of diagnoses with valid mental health resources, as necessary.

Ultimately, these organizations hope to inform writers that meaningful stories do not need to peddle incorrect and damaging stereotypes about the mentally ill. They have also initiated their own media campaigns to bring awareness to mental health stigmas.

The biggest advances in combatting stigma against mental illness have come through public policy

The passages of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), also known as Obamacare, have profoundly improved access to resources for the mentally ill.

mhpThe MHPAEA (2008) ensures that financial requirements (ex. Co-pays, deductibles) and treatment limitations (time of stay in hospital) for mental health or substance abuse disorder benefits are no more restrictive than corresponding surgical or medical benefits.

The ACA (2013) builds upon the principles of the MHPAEA and expands access to mental health services for geriatric patients in a number of ways:

  1. Employer-based insurance for seniors no longer can deny coverage based on preexisting psychiatric acaconditions.
  2. The ACA contains provisions that will increase quality of care in nursing homes.
  3. Healthcare institutions that are categorized as “Health Homes” or “Medical Homes” will receive increased federal funding, which will make mental health treatment more accessible for the disabled and elderly.
  4. All states will be required to have some level of mental healthcare coverage, though specific services are decided on a state-by-state basis.
  5. Medicaid has been expanded in 27 states. Medicaid’s broad range of mental health and community support resources mean that millions more people will be able to obtain treatment for psychiatric disorders.

Collectively, this means that mental health services will be more accessible than ever before to the majority of Americans, including geriatric patients. Though these policies are an important step forward, it is important to remember that social and self-stigmas are powerful factors in care quality and access, especially for seniors. Furthermore, the ACA only mildly addresses the most pressing issue facing seniors—the lack of geriatrics-specialized physicians and healthcare workers.

Fortunately, numerous colleges offer stipends and scholarships to encourage medical and graduate students to pursue specialty training in geriatric care. The American Association for Geriatric Psychiatry (AAGP) and the Geriatric Mental Health Foundation (GMHF) also support yearly scholarships for students who hope to obtain training in geriatric-focused medical care. As the Baby Boomer generation ages, these scholarships and programs will likely become more common in the nation’s medical colleges and healthcare training institutions.

Next week, we will discuss how practicing gratefulness in your daily life can improve your mental health.

Sound Body, Sound Mind

As our body goes, so goes our mind.
You know how you feel after a long car trip, when you finally get out of the car and stand up, you’re stiff and sore, right? Imagine years of not getting up. One day you’ll realize your body aches are chronic and your memory isn’t as sharp as it used to be. Most just complain and brush it off as old age.

Senior-doing-neck-stretches-350x234
You don’t have to live this way! Make yourself get up and do something aerobic at least 3 times per week. You could go on a walk, run, take a bike ride, invest in cardio equipment, or join a gym. Start slow and steady. Try to get your heart rate up for at least 20 minutes each time. Add in weight bearing exercise, flexibility and balance exercises, and notice your aches and pains diminish.

Find a Buddy
I recommend finding an exercise buddy to keep yourself on track. Those who exercise with a partner are much more likely to continue their routine. Motivating each other and holding each other accountable to your exercise schedule goes a long way in your success.penguinbuds

What’s good for your heart is also good for your mind
Each year that we don’t get the exercise our body needs, we age prematurely. Not only does your body start to deteriorate, so does your mind. Studies have shown that exercise can actually ward off dementia, Alzheimer’s, diabetes, and high blood pressure. According to Dr. Stephan Bamberger, PhD, Lac, “The connection between Alzheimer’s disease and blood supply to the brain, has recently been confirmed by researchers at the University of Leiden in Holland.” As your blood flow decreases, due to clogged arteries or blood clots, your body and mind will feel the difference.

3menAvoid Crippling Effects and Future Medication
• Exercise has been proven to:
• Improve your immunity
• Improve your cardiovascular function
• Improve your digestive system
• Protect against loss of bone mass with weight bearing exercises
• Improve your functional reach
• Improve your balance and flexibility
• Reduce pain from rheumatoid arthritis
• Reverse muscle atrophy

As a former fitness club owner, I witnessed the positive effects on the elderly, who happened to make up the majority of our membership. Two personal stories are testimonies to the need to begin or continue an exercise routine.

Virginia
The oldest member of our club was sharp as a tack, with memory better than most our younger members. She was (and still is) friendly and loved by all our members who came in to work out the same hours as she. Virginia drove herself and a friend to our club 3 x’s per week. She walked laps in our pool, stretched out in the hot tub, took a shower and afterwards, usually rushed out to meet some friends for dinner. We celebrated her 100th Birthday Party at our gym with her family and friends.

muscle_brain
Texas
Waiting in the dark in his car 3 mornings per week, Texas would wait until an employee arrived to open the door at 5:15 a.m. Texas proved to his doctor that he had what it takes to ward off the diseases that can come with old age. I met Texas when he was a young 75 year old gentleman. The previous year, Texas was told by his Dr. that he was going to die in 6 months if he didn’t start changing his ways. He was diagnosed with Type II diabetes and high blood
pressure. The very next day he joined a fitness center and started walking on a treadmill for and hour 3 x’s per week and started watching what he ate. In 6 months, his diabetes had disappeared and he was taken off his heart medication. Now 78 years of age, he continues his routine religiously each week, always with a smile on his face.
Allow Virginia and Texas to be your inspiration. Kick some of those painful signs of old age by making some lifestyle changes to improve your quality of life.
Always consult your doctor before beginning an exercise program.

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