Organised by:

Malaysian Healthy Ageing Society

Co-Sponsored:

PSYCHOSOCIAL

ASPECTS OF AGEING

AND MENTAL HEALTH

Dr. M Parameshvara Deva

Professor and Head

Department of Psychological and Behavioural Medicine

Faculty of Medicine

MAHSA UNIVERSITY COLLEGE

AGEING AND HEALTH

MOST FOCUS ON PHYSICAL HEALTH

TEACHING HAS EMPHASISED NEED

FOR PREVENTION OF AGE RELATED

DIABETES, HYPERTENSION WITH

RISKS OF CVS DISEASES

GROSS IGNORANCE OF MENTAL

HEALTH IN HEALTH CARE

THE MENTAL IN HEALTH

Health is a state of complete physical,

mental and social well being and not

merely the absence of disease Page 1, Para 1 line 2 WHO Constitution

22 July 1946

LONG ESTABLISHED, BUT POORLY RECOGNISED IN

CLINICAL PRACTICE - WORLDWIDE.

OVER 30% of PHC PATIENTS WITH SIGNIFICANT MENTAL

HEALTH PROBLEMS BUT PICK UP RATE OFTEN LESS

THAN 3 % - TREATMENT EVEN LESS

ANATOMY OF IGNORANCE

MENTAL ILLNESSES TOO OFTEN

ASSOCIATED WHAT IS LESS THAN

7% OF ALL EMOTIONAL DISTRESS

AND DISEASES

PSYCHOSES – (MADNESS) THOUGHT

BY EVEN DEANS OF MEDICAL

SCHOOLS TO BE ALL THERE IS IN

PSYCHIATRY

LONG HISTORY OF

POOR TEACHING – NO UNIVERSITY

EXAMS IN PSYCHIATRY IN WHOLE OF

INDIA’S 250 MEDICAL SCHOOLS 25

SCHOOLS HAVE NO DEPARTMENTS

OF PSYCHIATRY

BUT 15% OF POPULATION AND 30% OF

PHC PATIENTS HAVE SIGNIFICANT

MENTAL ILLNESSES REQUIRING

TREATMENT – GHQ STUDIES

PSYCHIATRY IN MEDICAL

AND NURSING SCHOOLS

LESS THAN 90 YEARS AGO

TOKENISM – TEACHING OF SEVERE

ILLNESSES IN MENTAL HOSPITALS

TURNED OFF MANY

93% OF MENTAL ILLNESSES NOT

SEVERE

COMMON MENTAL

ILLNESSES MISSED IN PHC

ANXIETY – DEPRESSION – 80%

SELF TREATED BY SUBSTANCE

ABUSE – cigarettes , alcohol, coffee – to

heroin

SUICIDES RARE BUT DRAMATIC –

DOMESTIC VIOLENCE COMMON

ANXIETY ILLNESSES

DEPRESSIVE

ILLNESSES

PSYCHOTIC

ILLNESSES SUBS

ABUSE

CHILD AND

ADOLESCENT

ILLNESSES

LIFESTYLE DISEASES(NCD)

OR LIFE STRESS DISEASES FOR

WHICH

PEOPE FIND OWN CURES

AND ATTRACT FUTURE HEART

DISEASE STROKES

THE MENTAL HEALTH OF

AGEING

ALSO OFTEN MISSED

POOR MENTAL HEALTH IN EARLIER

LIFE AFFECTS MENTAL HEALTH OF

ELDERLY

NCD – NON COMMUNICABLE

DISEASES BIG ISSUE – BUT NOT

ROLE OF MENTAL HEALTH IN NCD

COMPLICATIONS OF NCD

OFTEN SHOW UP IN ELDERLY,

OBESITY WITH COMPLICATIONS

CORONARY ARTERY DISEASES

STROKES

COAD

CANCERS

SIMILARLY EARLY

PSYCHOSOCIAL NEGLECT

AFFECTS MENTAL HEALTH IN

AGEING POPULATIONS

PRESENTS WITH HIGHER LEVELS OF

DEPRESSION, ANXIETY

RELATED TO POOR FINANCIAL

SUPPORT, FAMILY SUPPORT

INCOME ISSUES

IN ADULT WORKING LIFE INCOME

RISES WITH AGE AND EXPENDITURE

KEEPS PACE - as if there was no

tomorrow-

ON RETIREMENT INCOME DROPS BY

2/3rds BUT EXPENTITURE MAY RISE -

NOT FALL - and who will take the slack ?

PENSIONS, EPF

NOT RELIABLE AS WESTERN

ECONOMIES PROVED IN FINANCIAL

CRISES OF 2008 – Banks went bankrupt

COSTS GOING UP –PENSIONS

INCOMES NOT KEEPING PACE –

sustenance, housing, transport education,

allowances for children

DEPENDING ON

CHILDREN

CHILD ABUSE BEING FOLLOWED

CLOSELY BY PARENT ABUSE

THE ART OF BRINGING UP CHILDREN

TO CARE FOR AGEING PARENTS -

being lost

FAMILY RELATIONSHIPS

TYRANTS – REAP WHIRLWING IN LATER

YEARS AS CHILDREN, SPOUSE –

SHOUT MERDEKA !

THOROUGHLY SPOILING PARENTS TOO

REAP WHIRLDWIND OF CHILDREN WHO

COULD NOT CARE LESS WHO SHOUT

MERDEKA – AND ASK FOR MORE – IN

LATER YEARS

PHYSICAL HEALTH AND

MENTAL CONSEQUENSES

AGEING GRACEFULLY – STILL A

DREAM

PHYSICAL HEALTH MOBILITY

DECLINE

BRING MENTAL CONSEQUENCES

AGEING BRINGS MOST

SERIOUS ILLNESSES

AND DEMANDS SUPPORT FROM OTHERS

in cost, mobility, support for daily activities

AND NETWORK OF SUPPORTERS

DWINDLING FAST AS CHILDREN ARE

FEWER, FAMILIES ARE NUCLEAR, AFAR

DEPENDENCE ON FOREIGN MAIDS NOT

EASY, IS COSTLY

SERIOUS MENTAL

ILLNESSES OF LATER LIFE

CONTINUING MENTAL ILLNESSES,

Bipolar illnesses, Schizophrenia,

Dementias

Dementias are a sign of need for intense

care that is not always available As

many as 20 % of homes for elderly have

persons in this category

MANY PSYCHOLOGICAL

CHOICES MADE EARLY

HAVE CONSEQUENCES IN LATER

LIFE

HARD WORKING, THRIFTY, WISE

PLANNING INVESTMENTS

CHOICE OF SPOUSE

CHOICE OF CAREER

ADVICE WHEN MOST NEEDED IS LEAST HEEDED

NEGLECTING HEALTH

OVEREATING

SMOKING

HEAVY DRINKING

SEXUAL ADVENTURISM

NEGLECTING MENTAL HEALTH

PRINCIPLES

Good living habits

Good relationships

Good responsible habits

PSYCHOSOCIAL COPING

WITH AGEING

GUIDANCE ON SAVING

HEALTH (NCD as well as CDs)

INVESTMENTS

PREPARING FOR EMERGENCIES

GOOD SERVICES FOR EMOTIONAL

DISTRESS – counseling, home care,

emergency care to be available

BIG NEED

FOR AWARENESS IN HEALTH CARE

STUDENTS, MEDICAL, NURSING

HEALTH PLANNERS – TO CATER FOR

AGEING POPULATIONS AND NEEDS

POLITICAL WILL TO CATER FOR

AGEING POPULATIONS

TRAINING

IN AGEING AND PSYCHOSOCIAL NEEDS

OF SOCIAL WORKERS, COMMUNITY

CARE STAFF IN AGEING AND HEALTH

NEEDS

OF MENTAL HEALTH STAFF ON AGEING

** WHO

constitution - 1946

SG BULOH LEPRASORIUM HAS BEEN DE-STIGMATISED –NOT PSYCHIATRY

NO PSYCHIATRIC

BEDS !

THANK YOU