Okay, thank you.
First I'll say, in talking about seniors, I certainly didn't mean you in particular, so no.
In terms of issues of shame, solitude, etc., I think it comes back to the issue that we as a society, unfortunately, we do not treat older people well. Many times older people feel that there is no place for them in our society. We focus on youth and on productivity, and we mistake and mis-equate the value of a human being with their productivity in the workforce, and that's something we have to change. Quite frankly, if we change that I think it would do a world of good in terms of suicide prevention.
I'll say quickly that in one study of healthy aging, we asked many questions but also one simple question: how old do you feel? What we found is that their actual age wasn't really associated all that much with their felt age. People, however, who felt older tended to do worse. They tended to score significantly higher on measures of depression and loneliness, as you mentioned, and even thoughts of suicide. It really isn't as much how old somebody is, but how old somebody feels, and there is research showing that people tend to feel older if they're not doing well from a health perspective, which again supports the need for prevention, health and mental health, and good care.
Out of the three things I raised, what do I think would be most helpful to prevent suicide among older adults? Clearly, enhancing access to quality care and, yes, including enhanced access to psychotherapy and psychological care.
Briefly, as a follow-up to Mr. Young's question, for our psychotherapy study of older adults at risk for suicide, the majority were recruited from psychiatric services. All were either on antidepressants or mood stabilizer medications and were still struggling with thoughts of suicide.
With the addition of psychotherapy, a sensitive and supportive approach, and an evidence-based psychotherapy, we were able to help effect a significant reduction, if not elimination, of thoughts of suicide; a significant reduction in depressive symptom severity; and a significant improvement in psychological well-being, including a sense of meaning in life. So, again, not to say that one isn't helpful or that both together can't be, but I think we've only been focusing on one approach, the medicinal approach, for financial reasons, large waiting lists, etc., and we have to move beyond that.
Thank you for your thoughtful questions.