Stephanie Svec is the director of nonprofit Sante’s program that provides mental health counseling to homebound older adults. Photo courtesy of Sante

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Silvia (not her real name) had a busy life until she retired. But her life changed dramatically after that.

Growing health concerns, a dent in finances, and lack of supportive family or friends led to isolation, anxiety and depression. Although she received medical care for her physical ailments, she never sought help for anxiety and depression.

Silvia’s case is one example of the many older adults who live with mental illness that can easily be treated. The National Council on Aging (NCOA) states that depression, anxiety, addiction and other mental health issues are not a normal part of aging.

Yet one in four older adults experiences some mental disorder, and the number is expected to double to 15 million by 2030, according to NCOA, which warns that, left untreated, such conditions can lead to fatigue, illness and even suicide. So it is imperative to get help.

But some seniors are homebound and do not, or cannot, access services. To meet the needs of this population, Santé, a nonprofit organization that helps people with mental health issues, initiated the Seniors’ Services program to provide free counseling to homebound seniors in Montgomery County.

Stephanie Svec, director of Seniors’ Services, said Santé wanted to make mental health services available because some issues like grief, mild depression, and adjustment disorders were not being covered by insurance as they were not considered medically necessary to treat. While Medicare does cover some of these conditions today, it still doesn’t cover all of them.

“But these issues are very important for seniors because everything gets compounded faster and impacts their physical health,” Svec said.

The most prevalent issues Santé sees are depression, anxiety, grief, loss of identity (especially after retirement or forced retirement), age-related lifestyle changes, loss of mobility and independence, chronic pain and high blood pressure.

Some can’t walk well because of crippling arthritis, stroke, Parkinson’s, multiple sclerosis, kidney failure or cancer. Many don’t drive, and find it difficult to go out, particularly if they live in places where there is no convenient public transportation.

“Their world starts to get smaller, making it more depressing and difficult to cope,” Svec explained. “The thread that goes with everything is loss. Most have experienced loss of some kind, and cannot do what they did before.

“Although we have not seen anyone with a heroin or street drug problem, we commonly see addiction to prescription pills and alcohol [among older adults].

“The problem is, they don’t see themselves as addicts because the doctor prescribed the pills. They believe drug addicts don’t look like them. The truth is that the body gets addicted before the brain knows it,” Svec said.

Some have little or no family. Others cannot get along with their families. Some have no children, or they live far away. In many cases, close friends have died, and they have no social network to rely on.

“In the last five years, another issue we are seeing more of is paranoia and delusional thinking. [People say] ‘neighbors are doing something to me,’ ‘people are stealing my things,’ etc.

“We don’t know why this issue has increased. Maybe more people are being referred to us [for help]. Therapy won’t help much, and there is not much medication to help delusional thinking, unlike schizophrenia,” Svec said.

Started on a small budget, Seniors’ Services has expanded its staff and clientele to meet the growing need for counseling. The program was devised to offer 12 to 25 free counseling sessions per person, with most receiving 15 to 20 sessions.

To qualify for services, participants must want therapy, not be seeing other therapists, and be at least 60. However, Svec said exceptions have been made for people as young as 57.

The program, funded by Montgomery County, Md., is only for that county’s residents. Recognizing the need for similar services in the rest of metropolitan Washington, and for longer term counseling, Santé is set to launch a private pay service.

Svec also offers training on how to work with seniors who have mental illness, and does outreach to create awareness on how to cope with age-related changes. The goal is to intervene early, help prevent mental health issues in older adults, and treat those who need it.

Santé offers counseling to people of all races and religions in English, Spanish and Farsi, using interpreters for other languages, such as Mandarin, Cantonese, Korean and Russian. Therapists see about 150 seniors a year.

For more information, call (301) 572-6585, ext. 2190, or see http://www.thesantegroup.org.