Isolation Root Cause of Depression Among Elderly, Says HelpAge India Chief

On the eve of the International Day of Older Persons, non-profit organization HelpAge India, which works with and for the disadvantaged elderly, has launched a community-based initiative for the mental wellbeing of the aged named “Saarthak”.

The aim of the program is to enable non-specialized health workers and community care givers to provide effective treatment for mental health issues amongst the elderly and help them with their early diagnosis.

In an interview with Sputnik, HelpAge India's vice-chairman Rumjhum Chatterjee talked about the initiative, the mental health struggles the elderly face and how society can be more sensitive about it.

Sputnik: Could you tell us why your organization decided to launch “Saarthak”?

Rumjhum Chatterjee: Today is a very special day, because we are marking the International Day of Older Persons. In the HelpAge family, we have been discussing and considering all kinds of challenges faced by older people in India, especially over the past two years because of COVID.

We realized that the issues of mental health among the elderly were increasing, so we felt that it is time we should start working to tackle these challenges. Therefore, we launched “Saarthak”. It is done in collaboration with National Institute of Mental Health and Neuro Sciences (NIMHANS), and the Indian Government's program is also going to be supporting us technically.

We realized that there are not enough psychiatric professionals or psychiatric care facilities available to tackle the enormous number of people who need care for their mental problems. So, under this initiative we will assemble community caregivers who are not medically trained, but can at least provide the elderly with company so that they don't get isolated and depressed.

Sputnik: The population of the elderly in India is reported to reach more than 200Mln by 2025. Given this, how can a sufficient healthcare workers and community care givers be found to help this large number of seniors?

Rumjhum Chatterjee: This is the reason we need collaboration all round. The idea of launching this today is to flag up that we are definitely starting this initiative. Dr Vinod K Paul, a member of [government-sponsored think-tank] NITI Aayog, has also said that this needs to be replicated in as many states as possible.

To aid such a huge population that needs attention is going to be a huge challenge and everybody has to come forward.

Sputnik: What kind of technical support does the National Institute of Mental Health and Neuro Sciences (NIMHANS) provide under this initiative?

Rumjhum Chatterjee: NIMHANS will be providing medical support. The diagnosis will come from NIMHANS. With the help of NIMHANS we will assemble 10,000 non-specialist health workers and community care givers, focusing on geriatric mental health across the country, over a period of a year with the intention of growing over time.

The technical team from the Federal Health Ministry will also help us to reach out to those who need to be trained and how that will be rolled out.

Despite this, lots of partners are required. The corporate partners are also going to be an important part. The World Health Organization (WHO) has said it would like to partner. So we will need to roll this out in a systematic manner where we will see who is to be trained, what training is about, how that will be facilitated in the field, etc. So, it’s a program that needs very careful coordination.

Sputnik: Apart from providing healthcare facilities to the elderly under the Saarthak initiative, are they any other activities you plan to organize?

Rumjhum Chatterjee: Saarthak has been launched today but for the past 44 years we’ve been focusing on the issues - mainly health - of the elderly.

We have also been considering eyesight - not just cataracts, but also correcting vision and giving the elderly the right glasses which will enable them to do more than they have been.

Apart from this, we do a lot of work with the senior citizens who are able-bodied but need something to keep them busy because once they've retired at 60, it can be a problem when they don't know what to do with themselves. So, at least in urban areas, we have formed the elder citizens' associations so the elderly can get together there and take part in recreational activities.

We have also arranged a lot of digital-learning classes for them. So they can now operate their banks online and they are able to buy things online. And once they learn this, they are able to teach others.

Also, the eight old-age homes we have are also ways to build communities for the elderly. Therefore, Saarthak is about mental health and other programs are running parallel.

Sputnik: HelpAge India conducted a survey among 5,000 of the elderly in June 2021 which revealed that about 60 percent of them feel isolated and some 40 percent suffer depression. Did the survey also figured out the root causes behind these issues?

Rumjhum Chatterjee: Those who were suffering from depression already had a feeling of isolation which got worse and, therefore, they were in depression.

So, isolation was the root cause. Especially during COVID and the subsequent lockdown when the elderly were not able to be with those whom they knew and people were avoiding them because they were all confined to their home and in such circumstances people can get extremely anxious.

Apart from this, they were not technologically savvy enough to be able to connect digitally with people, order things online - as many of the rest of us can - conduct banking, etc. So isolation was far more serious.

Sputnik: Apart from isolation, what are the other common mental health issues the elderly face and how can we identify them at an early stage?

Rumjhum Chatterjee: Identifying the mental health issues at an early stage is a huge challenge because it takes years. So by the time we catch it, actually, the onset has been close to 10 years before that. But that's not a time when we are screening for mental illness amongst individuals, so we're already late.

However, a bigger challenge than identification is to make sure that those whom we catch at the early stage don't slip into dementia. They are at the depression stage only. But there are many causes and the study will tell us which of those we'll be able to pin down right now.

At least a victory has been won in that we’ve got everybody at one platform talking about mental illness, which until today was taboo. So if we can remove that stigma and recognize that the elderly who are suffering this way need help, I think we are on the right track.

Sputnik: Do you think that apart from providing support, the elderly should also be informed of their rights. Is HelpAge India carrying out any specific program related to it?

Rumjhum Chatterjee: Informing the elderly of their rights is a different and parallel activity that continues. HelpAge India is running a program where we tell them about their pensions. A lot of the elderly, particularly those in underprivileged economic section, didn’t even know that they were eligible for a pension.

In many states, we initiated this and have made it happen for the elderly. In some states, pensions were being given but only INR 1,000 ($12) per month. We petitioned the government that it’s not enough and it must be increased. So, that we've been able to do.

Sputnik: Discrimination against the elderly has been a major concern not only in India, but in western states as well. How do you think society can be better informed about it?

Rumjhum Chatterjee: That's exactly what HelpAge is doing with all its programs. The first thing we say is that the elderly must remain within the community. If family members are unable to provide connection directly, the community provides a connection with society and that is a good way to keep them engaged.

We get our health units to reach out to the elderly and we do not expect them to travel to hospitals many miles away. So we are giving them access to healthcare which would have been denied them if they were on their own.

We also operate a helpline, just like the helpline for childcare or for women. We thought that through this helpline, those who are in distress will reach out to us and talk. The fortunate part is that not all those who call the helpline for the elderly are actually in distress - some just want to speak to somebody, want to hear the voice of those people who manage the calls.

There are elderly people who call up and have songs sung to them. Helpline staff also ask about their wellbeing. Through this helpline we provide them with a way to stay in touch and give them somebody to talk to so that they are no longer isolated.