Help Seeking And The Older Adult



Help Seeking And The Older Adult

Derek Sharpe

Stenberg College

Sociology of Mental Health Nursing

201-3

Debbie McCreedy

July 12, 2013

Abstract

The object of this is paper is to provide evidence that supports psychiatric nurses developing and providing physicians with a “Personal Preparation Care and Action Plan,” (PPCAP) for older clients who assess for present and future risk of mental health and substance abuse, (MH/SA). A review of recent literature on MH/SA education initiatives and help seeking attitudes of older adults indicates their first professional contact for help will be with the primary care physician. The PPCAP is an excellent resource for the physician who lacks expertise in MH/SA and encourages a team approach to care while respecting the help seeking choice of the older adult.

Help Seeking And The Older Adult

The problem lies in recognizing and admitting one’s own need for professional help (Westerhof, 2008, p. 320).

In General, mental illness is prevalent. Roughly 30–50% of people will experience a mental disorder in their lifetimes, and 15–30% will have experienced a mental disorder in the past year (Mackenzie, 2006). Although interventions for substance abuse are not as effective as the interventions for depression, none the less, they are available (Bartels, 2002). However, large-scale epidemiological surveys clearly demonstrate that the mental health and substance abuse (MHSA) needs of older adults within and outside of North America are not being adequately met (Bartels, 2002). Education in the form of community initiatives that promote mental health and aging seem to be valuable, however, the impact of these initiatives to increase rates of mental service use or help seeking by older adults is hard to measure (Mackenzie, 2006). There is uncertainty about why and when or if an older adult will recognize and seek help for MH/SA. Obviously it is important to be ready when they do. When they do seek help, they will look to their family physician regardless of his knowledge of MHSA. This paper will examine recent literature regarding educational initiatives and help seeking attitudes of older adults. The writer believes that the literature supports a need for psychiatric nurses to develop a “Personalized Contemplative Care and Action Plan,” (PPCAP) for older clients who assess for present and future risk of mental health and substance abuse, (MHSA).

Educational Initiatives

Findings from a US county wide study to evaluate community awareness and knowledge about mental health and aging issues after a Mental Healthiness Aging Initiative are positive but more work is required (Zanjani et al., 2012). For example, the intervention counties had a better understanding of the risk of consuming alcohol and medications, but recognition of drinking problems in elder adults and the role of loss in depression/anxiety were poor (Zanjani et al., 2012). The researchers acknowledged study limitations and their recommendations for future research reflect this. Future research wants to know the following. Will more accurate community knowledge on important mental health and aging issues, result in higher rates of MH/SA detection and of proper clinical management leading to the improved health status of elder adults? This confers what the writer is saying about the value of education. The writer believes the reference to clinical management is the older adult’s first contact with the family physician.

Help Seeking

It is impossible to generalize results of studies exploring age and gender differences in attitudes toward seeking professional psychological help (Westerhof, 2008). At the same time it is well understood that the mental health needs of older adults are underserved (Mackenzie, 2006). According to Mackenzie, (2006), older age and the female gender possessed more positive help-seeking attitudes. Women showed more favorable intentions to use/seek mental health professionals than men. This was likely due to women having a positive attitude about psychological openness (Mackenzie, 2006). “Older adults exhibited more favorable intentions to seek help from primary care physicians (Mackenzie, 2006, p. 574). In general the study showed there existed negative attitudes about psychological disclosure which certainly might explain an underutilization of mental health services (Mackenzie, 2006). Also, help-seeking attitudes do not appear to be a barrier to older adults seeking professional help (Mackenzie, 2006). But more importantly, is that they intend to visit their primary care physician. So the intention to seek help exists. However, the effectiveness of the help will depend on the primary care physician’s knowledge of MH/SA.

From the information provided by the literature there are a couple of confident assumptions that can be made that support psychiatric nurses developing a PCCAP for older adult’s presenting with or at future risk of MH/SA. Firstly, MH/SA education is important and will make a positive contribution to clinical management. Clinical management is, in the writer’s opinion, a reference to the older adult’s primary care physician. Secondly, older adults choosing to seek help for MH/SA will look to their primary care physician regardless of the physician’s expertise in MH/SA. All help seeking roads for older adults with MH/SA lead to the primary care physician. It is through the physician that psychiatric nurses can access the help seeking older adult. The nurse’s assessment training and expertise in MH/SA can be operationalized for the older adult by developing a PCCAP. It is provided to the physician for reference when and if the client is seeks help. The document is a reference for the physician and it promotes a team approach to patient care. In this way the older adult will receive help regardless of physician expertise and in a manner that maintains their help seeking preference.

Personal Preparation, Care and Action Plan

The PPCAP derives its name from behavioral change interventions and more specifically the stages of change model (Stuart, 2009). The preparation stage of change is characterized by a person planning to act. Helping the person determine the best course of action is the goal at this stage (Stuart, 2009). This course of action is the PPCAP.

This paper looked at recent literature examining MH/SA education initiatives and help seeking attitudes of older adults. The literature indicates that MH/SA education initiatives are valuable but when the older adult seeks help for MH/SA their first professional contact will be with their primary care physician. The Author has provided strong evidence why psychiatric nurses should prepare PPCAPs for the older adult with MH/SA and provide it to he physician. It is an excellent resource in the absence of physician MH/SA expertise. It promotes a team approach to the care while respecting the help seeking choice of the older adult.

References

Bartels, S. A. (2002). Mental Disorders of Aging: An Emerging Public Health Crisis? Generations, 26. Retrieved from

Mackenzie, C. J. (2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging and Mental Health, 10, 574–582. Retrieved from

Stuart, G. W. (2009). Principles and practice of psychiatric nursing (9th ed.). United States: Mosby.

Westerhof, G. (2008). Intentions to seek (preventive) psychological help among older adults: An application of the theory of planned behaviour. Aging & Mental Health, 12, 317-322. Retrieved from

Zanjani, F., Kruger, T., & Murray, D. (2012). Evaluation of the mental healthiness aging initiative community program to promote awareness about mental health and aging issues. Community Mental Health Journal , 48, 193-201.

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