Mental health articles

mental health elderly people in developing countries

Developing countries are currently witnessing and will continue to witness large increases in numbers and proportions of elderly members in their populations.Since organic dementias are age-related, a higher prevalence of these disorders will emerge aspopulations age. Furthermore, the prevalence of non-organic mental disorders, such as depression andanxiety, are directly affected by stressors, such as war,ethnic conflict and the process of moving to urbanareas while lacking economic resources. The amountand nature of care received by elderly from theirfamilies are also important factors with regard to their non-organic mental health and are determined in partby factors such as the decline in value of agriculturalassets and changing inheritance patterns, growingparticipation of women in the labor force, migrationof younger family members from rural to urbanenvironments, and the access of younger familymembers to education.

Reliance on stereotypes of modern and traditionalsocieties can result in inappropriate policy ideas. Byassuming that families in countries of the developingworld confer more respect to their elders and are moreinclined to care for them, the role of the state inimplementing useful policy may be downplayed.

However, given the demographic transition andconcurrent social, cultural and economic changes indeveloping countries, careful planning by governmentis needed to originate policies that strengthen informaland formal care systems. Since many of these countriesare financially burdened and face other serious socialand political problems, inexpensive targeted anduniversal policies are desirable. It is ditiicult to makebroad policy and program recommendations fordeveloping countries, given their economic andcultural heterogeneity, and planning must occur inlocal contexts.

Currently available research is incomplete inproviding information useful in planning services and prevention efforts. Chandra et al. state, "Differencesin rates of occurrence [of dementing disorders].., indifferent societies will help focus the search for riskfactors and etiological clues". Unfortunately,despite Harpham's  assertion that the"growing number of studies on the mental health of…the elderly" merits a review separate from thatconcerning general populations, we have found thatfew studies have actually focussed exclusively on theelderly. Furthermore, a limited number of epidemiologicalstudies on elderly mental health have beencompleted in developing countries, and the availablesmall-scale studies are rarely comparable in ameaningful way. This is, in part, a result of the use ofdifferent instruments and/or diagnostic criteria or theuse of the same instruments in different countries butin a way that does not account for bias due to culture,education and socio-economic status. If overall ratesof age-related disorders differ among older populations,this may be due to considerable variation in theage structures of the populations. Thus, for example,it is difficult to accurately determine whether dementiais truly less prevalent in sub-Saharan Africa than inother parts of the world, as suggested by some studiesreviewed earlier.

In conclusion, this paper has drawn on empiricalevidence from diverse bodies of literature to create apreliminary conceptual 'model of forces' influencingthe mental health of the elderly. Each of the model'scomponents deserves further inquiry. For a phenomenonthat can impact mental health directly , studies need to bedesigned in such a way as to measure the effect ofspecific risk factors associated with the phenomenon(for example, in the case of war or ethnic conflict, deathof a loved one or repeated exposure to violence) oncertain mental health problems  for good examples of thistype of research). Furthermore, it is quite apparentfrom the anthropological literature cited during themodel's presentation that the family care system forthe elderly is changing in many developing countries,and it is critical to determine how these changes bearupon elderly mental health. Through what specificmechanisms does lack of family and social supportinfluence non-organic mental health? What types ofsituations of family and social support are associatedwith low and high levels of psychiatric morbidity among elderly populations? Because the social andcultural dimensions of mental illnesses like depressionare often neglected by purely quantitative studies,research intending to answer these types of questionsshould include a qualitative component.The mental health of the elderly and its demographic, economic, social and cultural determinantsdeserve increasing attention from researchers aspopulations age rapidly around the world. Further investigation into topics presented in this paper,keeping in mind the limitations of existing research,will provide knowledge of practical significance for the mental well being of the world's elderly.

 

Tags: elderly people, Health, mental, Mental health