The wellbeing of older people is a growing concern for both the suicide prevention sector and wider community. Sadly, men aged 85 years and older have the highest rate of suicide – something that is not commonly known.
There are a range of environmental and lifespan factors that can increase the risk of suicidality among older people. These can include moving into retirement, residential aged care transition, bereavement, and loss of independent living due to health or disability conditions associated with aging. However, two of the major reasons older people experience distress are loneliness and social isolation.
Approximately 36 per cent of the rural Australian population are aged 65 years and older. In fact, many rural and remote communities have higher proportions of older people than metropolitan centres. We also know living regionally can exacerbate feelings of loneliness and isolation.
So, what can be done to better support older people when they’re experiencing distress? We need to equip the rural and regional workforce with appropriate skills and knowledge to respond to older people in distress and ensure that alternative approaches (like community-based supports) are explored. Further funding to boost the workforce is also essential so there is adequate capacity and capability to identify early those in distress and provide tailored solutions.
Older people have different needs to the broader adult population, and suicidality is often not explicitly expressed due to the focus on physical health issues, ageism and stigma surrounding underlying mental ill health.
Suicide prevention efforts need to be targeted to address older people and be tailored to the risk factors for suicide associated with aging. As they are less likely to seek help for mental ill-health concerns in formal or clinical settings, supports for older people at risk of suicide should be co-designed with older people.
Governments should fund specific mental health and suicide prevention services for older people, including tailored aftercare, postvention, in-reach service provision into residential aged care, and targeted supports at key life stages of transition and social demographics. This approach will address an already stretched workforce and ensure that solutions are available in settings where older people are living and congregating.
Studies show that many older people have contact with a general practitioner (GP) in the weeks before self-harming. However, GPs reported lacking confidence, appropriate skills and referral pathways to support these patients. Primary healthcare providers are often not equipped to provide expert assessment and care planning for complex needs and may not see it as their role to do so.
GPs, nurses and health workers should be trained in suicide prevention specific to older people that targets stigma and ageism in assessment and treatment.
State and territory governments should roll out targeted community connector training for face-to-face workers who are likely to encounter older people who may be experiencing suicidality. This is to ensure older people receive the support they need and the workforce feels empowered and equipped with the relevant skills to support older people in distress.
Alternative and innovative approaches to addressing loneliness are emerging overseas. For example, ‘social prescribing’ or ‘non-medical prescribing’, which involves healthcare providers referring people to existing community-based, non-clinical supports. These may include social support services, volunteering opportunities, arts activities, community gardens or other community groups.
Governments should support alternative measures to address social isolation and loneliness among older people as part of primary healthcare and preventive strategies, including funding to support the ‘link worker’ and peer workforce.
Older people are often the pillars of our communities. We need to work together to reduce stigma around aging, ensure they have a sense of belonging built through meaningful connections, and have access to timely and customised support, both clinical and non-clinical.