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SRQ 5

SRQ 5

Maria Theresa Dizon

OHSU PSU School of Public Health
AGE 560: Aging and Mental Health
Dr. Bryant Carlson
May 1, 2022
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SRQ 5
This week’s material centered on late life suicide risk and substance abuse in older
populations. Untreated depression can lead to substance abuse and self-harm. It is reported that
85% of older adults die by suicide (PSU Institute on Aging, 2018). The Portland State’s Institute
on Aging’s video about George who is facing significant substance abuse issues and depressive
symptoms showcases how older people can easily feel like there is nothing left for them in the
later stages of life and that suicide becomes something that they contemplate. In order to cope,
George uses alcohol. In the video, it stresses that there are many people in his community that
can play a role in recognizing symptoms and/or behavior that would concern in George. People,
such as community members and employees of organizations that interact often with the public,
have the opportunity to check in for their welfare.
In checking in for their welfare, an official may conduct a suicide risk assessment. In
order to properly conduct one, the person must be clean and sober. Examples of what is asked
during the assessment include: Do they have a history of suicide attempts? Any previous
depression issues or being on medication for it? Another interesting component brought up in
this week’s material is the Reasons for Living Scale, which is a rated scale questionnaire that
lists common answers that people would answer for not committing suicide. To me, this is a
good tool for the people to fill out and prompt to reflect on their family ties, child-related
concerns, social beliefs, and the drive to live.
George’s experience and voicing out his needs was very similar to the evidence found
after participants engaged in the Problem Solving Therapy (PST) program for 12 weeks. Older
populations may face deficits in problem solving abilities as it is more pronounced in older
adults, especially those with a history of suicidal attempts (Gustavson et al., 2016). PST is
helpful because it teaches people how to clearly define problems, weigh out the pros and cons of
their decision-making, selecting an achievable solution and enacting an action plan. George
shared that it was important that any treatment or solution would have to be about educating the
person, centering them, and have changes to lifestyle such as increasing the outlets for
meaningful social engagement (like volunteering).
Another similarity to the findings of another study about what were the preferred
treatments for older adults with substance abuse problems with what George shared is that
people simply want to be seen as a person, treated with genuine care, given the proper attention
and warmth, and to ensure the programs available are accessible (Holland et al., 2016). Other
treatments tend to be punitive, confrontational, and stringent in nature, which makes it a difficult
environment for people to be vulnerable and fully participate in their own healing. An important
stand out piece from this study is that participants were able to pick up on whether their
providers were stressed and did not take care of themselves, as they were very aware that their
jobs were emotionally and mentally taxing. This goes to show that on the flip side, providers
should also have opportunities for self-care as well.
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Question:
 Programs for older adults tend to lump them all as seniors. Would a more specific group
by race and ethnicity be more helpful to tackle issues related to substance abuse and
mental health issues, considering the nuances and differences in culture?

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References
Gustavson, K. A., Alexopoulos, G. S., Niu, G. C., McCulloch, C., Meade, T., & Arean, P. A. (2016).

Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive

Dysfunction. The American Journal of Geriatric Psychiatry : Official Journal of the American

Association for Geriatric Psychiatry, 24(1), 11–17. https://doi.org/10.1016/j.jagp.2015.07.010

Holland, J. M., Rozalski, V., Beckman, L., Rakhkovskaya, L. M., Klingspon, K. L., Donohue, B.,

Williams, C., Thompson, L. W., & Gallagher-Thompson, D. (2016). Treatment Preferences of

Older Adults with Substance Use Problems. Clinical Gerontologist, 39(1), 15–24.

https://doi.org/10.1080/07317115.2015.1101633

PSU Institute on Aging. (2018). Serving Older Adults with Behavioral Health Needs: Module 6. PSU

Media Space. https://media.pdx.edu/media/t/0_ea3pym8z