How to Talk with Older Adults About Mental Health Problems. Expert Tips from a Geropsychologist
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So you're noticing signs and symptoms of depression or anxiety. What now? It can be very helpful to start a conversation with your older client about what's actually happening.

You might start by just validating and being empathic with what the person just shared with you.

"You're going through so much, there have been so many changes to your body. This is impacting how you're feeling emotionally. And what if I told you there might be some very good support for this. Would you be open to hearing about that?" And hear what the person says. If they say yes, then you might provide a little bit of education.

Like "sometimes these changes can be due to something physical going on in your body. And sometimes it can be due to adjusting to difficult life changes. Psychologically. And the good news is that we can help get you connected to your doctor for the physical. And also once that's optimized. They can help you get connected to a mental health professional so that both parts of your life are cared for and held" So that might be one way to start a conversation.

There are some misconceptions about what's normal with aging that actually get in the way of older adults receiving mental health care.

Let me give you an example. One of the misconceptions about what's normal with aging is that. You, you may have heard depression is normal with aging. Anxiety is normal with aging. That is not true. Depression and anxiety are not normal with aging and deserve to be investigated and treated when they arise. Another misconception is that older adults are rigid and won't change.

And that is also not true. We know that treatment for mental health conditions. Is highly effective for older adults. And so you might also have to dispel some of these myths with the older adults as well.

I'll often say "you might be surprised to hear this, or you're not alone"

So that's the other thing, as you're starting a conversation, you might also tell the person you're working with that they're not alone and use compassion to help bridge them to care and to services. So "you're not alone with this. You don't have to carry this all by yourself. I'm here to help you. We can bridge you to your primary care provider and they can help investigate. What's actually going on and get you the support and care you deserve." So that's how I would start the conversation.

Now. What if the person, protests and the conversation doesn't go well, . Every conversation is nuanced, but I think it is okay to acknowledge what is happening between you. So you can say, "gosh, I see, this is not going well. And you're having a big reaction to what I said. And I'm so sorry." I think be quick to acknowledge and apologize where needed. "This isn't going, like I had hoped. And I'm so sorry if I misstepped or I misjudged the situation. That was not my intention, but I see it's impacted you." Give them a moment to respond. And then take a step back and ask, "help me understand what you're trying to share with me. Now I'm going to be a better listener now, help me understand what I was missing." Foster an opportunity to try the conversation again, but you might have to put your ego aside. And, apologize, acknowledge that this interaction hasn't been going well. To take a step back and to say, "let me try again from a new vantage point from one where I'm not trying to convince you, but open to receiving what you're trying to tell me."

Then approach the conversation with an open stance. So you're receiving what the person was trying to tell you in the first place. Ultimately the vast majority of older adults can make choices about their mental health care without any input from others. And so if they're saying they're not ready for mental health care, I say respect it.

You can say something like, "I hear that this is not the right time for you to make any changes. And I respect that. If you change your mind, I will be here to help you." Period and then move along. I can't tell you how many times. An older person comes to my office. We talk about the mental health needs and concerns that they have in our first meeting. I give recommendations.

Like I think psychotherapy might be very helpful for you. Maybe even medication management could be very helpful for you. And then I say, here's what I have to offer. Here's what I recommend you. Tell me what you would like to do. And sometimes the person says, I don't know, And then I say, oh, here are some things you could do. We could take this information and think about it.

You can start with one avenue that I've recommended and see how it goes or not at all. It's really your choice. The more the person. Really believes that you have their best interest and autonomy in mind, the freer, they are to make a choice for themselves. And let them know that they choose one option. Now they can change their mind later. It doesn't have to be, this is the decision for the rest of their life.

I also like to remind folks it's not your job to convince a person to get care. It's our job to let people know what care is available to them. And if we can help them. A bridge to care and services, but we don't have the right to choose if they engage in that care or not. And our role is really to respect the person's autonomy and wishes.

Our job is to respect the person's process in that. And to be here when they need it. Without judgment. And with willingness to help.