January 29, 2007
Monday

Suicide among baby boomers has run ahead of the national rate at every stage of their lives, and experts are worried that suicide among the elderly, already high, may double in the next 20 years.

They warn that despite many advances in understanding and responding to suicide risk factors among Americans of all ages, the nation's youth-oriented culture, lingering stigmas toward mental illness and the medical system itself leave aging boomers in greater danger.

A Scripps analysis of the causes of death among boomers in 2003 found that 11,667 took their own lives, representing 37 percent of all suicides in the United States that year. By contrast, there were 3,988 suicides among 15- to 24-year olds that year, and 5,248 among people 65 and older.

Ninety percent of all suicides in the United States are linked to depression or substance abuse, problems that have plagued boomers since they were teenagers and remained more prevalent throughout their lives than among previous generations.

"One of the biggest things we're up against is the notion that it's normal to experience depression when you get older," said Jerry Reed, executive director of the Suicide Prevention Action Network.

While there are plenty of traumas associated with aging _ changing or ending careers, changing living arrangements, declining health, loss of a spouse, "there is no natural reason why an older person should have to suffer from depression," Reed said.

Dr. Yeates Conwell, a professor of psychiatry and co-director of the Center for the Study and Prevention of Suicide at the University of Rochester, agrees that given the size and historic risk factors of the boomers, "both the rate and absolute number of suicides (among the elderly) may rise dramatically in coming decades. Recognition and effective treatment of depressive illness in older adults is at the top of the list of preventive strategies."

Suicide rates among senior citizens have actually seen a slight decline in the past decade, but the rates remain well above those for teens and young adults.

Reed said, "We can't wait until boomers are 65 to start talking about mental health. We know there are far too few geriatric psychiatrists and mental health centers geared to older patients, but we also know most older adults are under fairly regular care from a physician. The key is to get primary care providers to ask questions about how a patient is feeling beyond physical health."

Getting older patients to accept that they may be depressed or addicted may still be difficult, but Reed and others say that as a group that has battled stress and excess since youth, boomers may be "more tolerant of an illness, whether in the brain or the body."

Many experts say boomers have tended to set high expectations for themselves all their lives, and that this drive to excel has elevated stress and makes boomers more likely to become depressed when things don't work out as planned, whether it be a job, a marriage or failed health.

Only 30 percent to 50 percent of all adults with diagnosable depression get adequate treatment, and senior citizens face particular economic disincentives to get mental health care through Medicare, Reed noted.

While the federal health insurance program has 20 percent co-pays for medical treatments, the co-pays rise to 50 percent for mental health care. "We don't have equal coverage for brain illness compared with body illness, and without that, older patients don't have equal access to care and we lose an important tool in preventing suicides," Reed said.

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