108th Congress

Senior Depression: Life-Saving Mental Health Treatments for Older Americans
Senate Special Committee on Aging

July 28, 2003

Witness:

Dr. Jane Pearson, Associate Director for Preventive Interventions and Chair of the Suicide Research Consortium, National Institute of Mental Health

The purpose of the hearing was to examine the need for improved treatment for depression and suicide prevention in the aged population. In opening the hearing, Senator John Breaux (D-LA), Ranking Member, noted that the mental health problems of the elderly are too often ignored or go untreated as a normal sign of aging. Senator Breaux said that it is time the country recognized that depression is a real problem for our nation's seniors, and diagnosis, treatment, and prevention must be a high priority.

• Dr. Jane Pearson testified that persons aged 65 and older comprised 18 percent of all suicides, even though the elderly only comprise 13 percent of the United States population. In the United States and other industrialized nations, older males have the highest rates of suicide. In this country, it is older white males with the highest rate (of suicide), comprising 81 percent of all elderly suicides. Early indications of these patterns led NIMH, in 1997, to issue an RFA, "Prevention of Suicidal Behavior in Older Primary Care Patients" to test models of depression and suicidally recognition and treatment. The outcome of the RFA was the funding of a three-site study entitled, "Prevention Of Suicide in Primary Care Elderly: Collaborative Trial [PROSPECT].
• Dr. Ira Katz, Professor of Psychiatry, Director, Section of Geriatric Psychiatry, University of Pennsylvania, School of Medicine, testified that since the Committee's first hearing on this issue in 1996, there have been significant changes in the care of depression, including the increased availability of newer and safer antidepressant medications and evidence that specific forms of psychotherapy are effective in the elderly. However, there are still major barriers to the effective treatment of late life depression. There is still a high degree of stigma associated with the diagnosis of depression. In addition, high co-payments for mental health services in the traditional Medicare program remain, and the proportion of managed care expenditures devoted to mental healthcare has actually decreased.
• Dr. Donna Cohen, Professor of Psychiatry, Director, Section of Geriatric Psychiatry, University of Pennsylvania, School of Medicine, testified that depression can be lethal. Seventy-two percent of older persons use firearms to commit suicide, compared to 57 percent for the general population. The aged are less likely to have failed attempts at suicide.
• Other witnesses testified about their personal and family experiences with depression and suicide.