mental health

A Caregiver’s Near-Suicide

An article on “caregiver burden” in the March 12 issue of JAMA (Journal of the American Medical Association) opens by describing a painful, nearly fatal, situation: Mrs. D, at 84 years of age, was the primary caregiver for her functionally impaired 86-year-old husband and shot herself 3 times in a suicide attempt. Mrs. D’s family […]

Suicide among the Elderly

In terms of cost savings, suicide among the elderly would be quite effective. Perhaps “suicide panels” would be as successful as the imaginary ”death panels” that caused so much consternation as healthcare reform was being processed. A ready-made theme song for “suicide panels” could be “Suicide is Painless“, the theme song from the hit TV […]

The Medicare Social Club

Days from her 80th birthday, “Nancy” (not her real name) is doing well.  She’s active, exercises, drives, travels, and lives alone in a multi-story apartment building without an elevator.  Her busy schedule of weekly activities includes several appointments with physicians.  Nancy’s medical needs are covered by Medicare. Nancy’s been in psychotherapy for a half-century.  She’s […]

A New Direction for Geriatric Psychiatry: Wellness

In his farewell address in May as the outgoing president of the American Psychiatric Association, Dr. Dilip Jeste emphasized the need for a “positive psychiatry of aging.” Until recently, psychiatry has largely conceptualized health and well-being as the absence of illness and symptoms. In Jeste’s view, “quality of life and psychosocial functioning depend less on […]

Mental Health Care for the “Silver Tsunami”

On January 23 the New England Journal of Medicine published “The Underside of the Silver Tsunami – Older Adults and Mental Health Care.” The article draws on an Institute of Medicine report on the mental health workforce for older adults that Peter Brown, executive director of the Institute for Behavioral Healthcare Improvement, discussed here on […]

Accountable Care Sprints Ahead

A recent report from the Oliver Wyman consulting firm – The ACO Surprise – argues that accountable care organizations are on the verge of triggering a major transformation of the U.S. health system. I hope this prediction comes true.

Struggling to Meet Seniors’ Behavioral Health Needs

In July the Institute of Medicine issued a report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?  The point of the report was to call serious attention to the growing inability of the health care workforce to meet the behavioral health needs of the senior population.