与年龄有关的风险和不平等对晚年心理健康的影响

A. Milne
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摘要

从广义上讲,有两组与年龄有关的心理健康风险。第一类是直接由晚年生活中常见的经历和损失引起的,包括身体不健康和/或残疾、成为照顾者、退休和丧亲之痛。这些与心理健康受损和抑郁风险增加有关,特别是在经济或社会资源匮乏的老年人中。第二种风险来自年龄歧视和年龄歧视,以及它们与其他类型的歧视的交叉,如对老年妇女的性别歧视。直接和间接歧视普遍存在;它涉及社会的所有领域,包括保健和社会保健服务。它严重损害老年人的心理健康,并与恐惧、无助、低自尊、焦虑和抑郁有关。它还与排斥、边缘化和虐待有关。近年来,一直在努力确保将老年人公开纳入旨在改善人口身心健康的政策;这包括获得治疗,例如抑郁症的治疗。此外,还注重解决就业和心理健康服务等具体领域的年龄歧视问题。这些举措成败参半。
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The impact of age-related risks and inequalities on mental health in later life
In broad terms there are two sets of age-related risks to mental health. The first set are those arising directly from experiences and losses common to later life, including physical ill health and/or disability, being a carer, retirement, and bereavement. These are associated with impaired psychological wellbeing and heightened risk of depression, particularly amongst older people with few economic or social resources. The second set of risks arise from ageism and age discrimination, and their intersection with other types of discrimination such as sexism for older women. Direct and indirect discrimination is widespread; it is located in all areas of society including health and social care services. It is profoundly damaging to older peoples’ psychological wellbeing and is associated with fear, helplessness, low self-esteem, anxiety and depression. It is also linked to exclusion, marginalisation and abuse. In recent years there have been efforts to ensure that older people are overtly included in policies intended to improve the population’s physical and mental health; this includes access to treatments e.g. for depression. There has also been a focus on addressing age discrimination in specific arenas e.g. in employment and mental health services. These initiatives have had mixed success.
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