Governments are contributing to the decline of mental health in older adults as they embrace neoliberal policies that encourage the prioritization of profit over people.
In a new article, researchers Lauren B. Airth and Nelly D. Oelke found a lack of policies and strategies offered by governments and international organizations that support the mental well-being of older adults. This is a worrying trend, especially as the population of older adults will approximately double by 2050.
Airth and Oelke argue that neoliberal ideology leads to systemic issues in policies that impact older adults’ mental health:
“Because of the shift towards neoliberalism, citizens’ well-being has become a commodity rather than a right. Care for older adults’ mental health translates to expensive, private organizations which force those who are struggling, or their caregivers, to find the means to pay for adequate services or suffer without professional help.”
The privatization and corporatization of healthcare are actively leaving behind those who cannot afford to manage their healthcare by consuming services and products on the market. In this way, international organizations and federal governments pass the responsibility for older adults’ health to their family members and immediate communities.
However, we already know that governments dedicating spending to social services and healthcare improves well-being and life expectancy. Research has also shown that investing in social welfare is directly beneficial to the individual citizen and could save money in annual health care costs.
Neoliberalism is not the only driving force here, as ageism and stigma are also at play. On this, Airth and Oelke quote the National Ageing Research Institute:
“The National Ageing Research Institute states ‘ageist behavior is common in medical settings, including a tendency to patronize and listen less to the views of older patients, order fewer diagnostic tests and attribute symptoms to age, rather than treatable conditions.’”
They continue by explaining that neoliberal policies focus upon an individual’s capacity to contribute, therefore giving less credence to the needs of older adults (among other groups). The authors describe a feedback loop that reinforces ageist behavior. As governments continuously outsource healthcare to non-government organizations, older adults interact increasingly less with the government and less with healthcare providers. As a result, policymakers will pay less attention to the concerns of this group.
Airth and Oelke found that older adults are likely to face more stigma when dealing with personality disorders and substance use. They also found that stigma experienced by older adults with depression is predictive of their decision to end treatment. Worse still, older adults may be blamed for their misunderstanding of privatized health systems—meanwhile, these systems truly are complex, and such criticisms only push people further away from the help they need.
“The negative beliefs and perceptions regarding mental health concerns comingle with negative associations with aging and have built a community of professionals who are unwilling to engage in policy reform on this topic. HCPs, with this stigma regarding mental health concerns for older adults, act as a barrier to services and may shame older adults who would be willing to speak up, to be silent.”
The current path that older adults must take to receive help with mental well-being is not sustainable, especially as the proportion of older adults increases globally. If we do not see change, Airth and Oelke point out that an increase in preventable hospital admissions will come at a cost to citizens.
Airth and Oelke include a checklist created by the WHO (and an extension to that checklist) that details how policies should be considered in the future. Importantly, the authors clarify that neoliberal goals of profiting off of mental health concerns and ageism and stigma must be accounted for when developing new policies that affect older adults.
Policymakers need to create a clear, updated, and reflective outline of their values that aligns with older adults’ needs. New Zealand has done a remarkable job of developing such an outline; Airth and Oelke find that other countries need to follow suit as the population of older adults increases.
Updating frameworks and strategic goals for policymaking are the change needed, as it is not necessarily the poor policies of federal governments but the lack of new policies that create a rift between older adults and the help they are seeking.
Airth, L., & Oelke, N. (2020). How Neoliberalism, Ageism and Stigma Drive the Lack of Policy for Older Adults’ Mental Health. Journal of Psychiatric and Mental Health Nursing, 27. (Link)