In 2017 the National Institute of Mental Health surveyed the population to reveal the number of people in the United States who were treated for mental illness in the previous year.
One of the cohorts surveyed was adults over the age of 50.
The survey included the conditions of mood, anxiety, eating, impulse control, substance use, and adjustment disorders. Left out were ADHD, autism spectrum disorder and schizophrenia and other psychotic disorders.
Categories were broken into Any Mental Illness (AMI), defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment.
Also defined was Serious Mental Illness (SMI), a subset of AMI defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.
Bipolar disorder 1 and 2 fall into the SMI category.
The prevalence of AMI for adults over age 50 was 13.8%, compared to 18.9% of all adults. 44.2% of the older population reporting AMI received mental health services, compared with 42.6% of the entire adult population with AMI.
It is striking to note that fewer than half of the adults that met diagnostic criteria for AMI received inpatient or outpatient treatment or therapy or any prescription medication for their condition in the entire surveyed year.
The prevalence of SMI for older adults was reported at 2.7%. 4.5% of all US adults reported a diagnosis of an SMI.
Several reasons may explain the much lower prevalence of serious mental illness in the elderly. Perhaps diagnostic criteria were more narrow, which they were, when the senior adults surveyed were younger and first diagnosed. They missed the surge in fad diagnoses that plague conditions like bipolar disorder among the young today.
Also, SMI greatly affects longevity. The average age of death for a person with bipolar disorder is 56. That would remove a large number of people over 50 with the disease from the survey, as they’re dead.
Treatment rates for the elderly with SMI were promising. 75.6% of older Americans with an SMI received services in the surveyed year, compared with 66.7% of the total adult population. 23.9% more women received services than men, which is upsetting because the highest suicide rate is in white men over 45.
As for bipolar disorder, 2.8% of US adults had bipolar disorder in the surveyed year, with 82.9% of those sampled with bipolar disorder considered serious, the highest percentage of serious impairment among the conditions surveyed.
The age breaks for older adults with bipolar disorder narrow to illustrate the effects of co-morbidity and early death. 2.2% of those aged 45 – 59 report bipolar disorder. For the group over age 60, only .7% report bipolar disorder. There is no miracle cure. The rest are gone
The data on SMI and bipolar disorder among the elderly reveal the severity of the problem with co-morbidity and elder suicide.
The accuracy of the results is limited by the fact that data was taken by questionnaire, and people who chose not to complete the questionnaire were not counted. Also, no one in nursing homes or long-term hospitals were included in the survey, and doctors often miss signs of mental illness in seniors, so results for the elderly are probably underreported.
32.9% of the subjects included in the survey did not complete the questionnaire. Researchers acknowledge that this group may be disproportionally skewed to have a mental illness.
The study proves that services are being provided for seniors with SMI. Earlier intervention on conditions co-morbid with mental illness, those physical conditions that lead to early death, may be warranted.
And more resources aimed at reducing the suicide rate found in older adults, especially older men who kill themselves at a rate 30% higher than the national average for all Americans, is imperative.