Many NJ Seniors at Risk for Depression, Government Survey Shows

Andrew Kitchenman | February 4, 2014 | Health Care
Federal report provides snapshot of Medicare recipients’ mental health before and after Hurricane Sandy

The counties hit hardest by Hurricane Sandy had a large population of seniors who were at risk of suffering from depression – but few of them had been screened for the disorder before the storm struck.

This information about the region’s Medicare recipients is included in a series of federally funded reports that provide a snapshot of older residents’ mental health on the eve of the devastating storm.

The data may help officials target where assistance should be provided in the future.

The 10 initial profiles were prepared by the nonprofit Healthcare Quality Strategies Inc. (HQSI), which receives Medicare funding, with a goal of improving Medicare services in the state.

HQSI officials said that the data provides a unique opportunity to study how the storm affected the mental health of Medicare recipients, adding that the information may lead to improved screening of older residents at risk for developing serious illnesses and disorders.

It’s too early to say whether those at risk of depression suffered from it at a higher rate after Sandy, since the organization is still gathering data from the post-Sandy period.

Medicare recently began covering the cost of depression screening, noted HQSI quality improvement specialist Judith Miller.

The organization want to learn as much as it can about how Sandy affected Medicare recipients so community stakeholders — including county offices on aging, hospitals, local government, nonprofit agencies and behavioral-health professionals — can strengthen services “for those who need them today and better prepare for tomorrow,” Miller said in a statement.

“Older adults are especially vulnerable to physical and behavioral health issues after a disaster,” she added. “Since depression can affect physical health, screening is an important tool.”

The county profiles found that for every 1,000 Medicare recipients, there were 175.56 people who had one of five factors in 2011 and the first nine months of 2012 that put them at risk for depression and anxiety problems. The five risk factors were: Alzheimer’s disease and other dementia-related disorders, sleep disturbance, alcohol/substance abuse or tobacco use, broken hips or pelvises, and amputations.

However, there were only 4.81 depression screenings per 1,000 Medicare recipients in 2012. The storm struck on October 29 of that year. Medicare Medicare began covering the screenings in October 2011.

While the county profiles include some information covering the first five months after the storm, HQSI officials said it was too early to draw conclusions from the data. They are gathering more information on the later months to draw a fuller picture of how the storm affected residents of hard-hit areas.

Some of the early data from the 10 counties included in the studies doesn’t reflect the changes that might be expected.

New diagnoses of depression, anxiety and adjustment disorders in the last quarter of 2012 and the first quarter of 2013 were similar to the rates before the storm. New diagnoses of post-traumatic stress disorder also didn’t change dramatically.

But there were some changes that may draw a closer look from public health officials. For example, the number of new cases of alcohol or substance abuse among Ocean County Medicare recipients rose 64.6 percent from the first quarter of 2012 to the first quarter of 2013.

Carol Benevy, who helped HQSI prepare the report, said it shows that there are opportunities to increase depression screening. She has headed a team of 21 crisis counselors in Ocean County on behalf of New Jersey Hope and Healing, a federally funded disaster recovery program.

She said it’s best to provide depression screening as part of other routine healthcare measures, since people frequently avoid seeking help for mental or behavioral health, due to social stigma and popular misconceptions.

“People don’t understand what is normal” behavior after a disaster, Benevy said, noting that failing to address symptoms of depression, for example, could increase the chances of full-blown mental illness.

Benevy said HQSI’s project offers a unique chance for public health experts to better understand the healthcare needs of Medicare recipients in the counties affected by Sandy and its aftermath.

“It was a very thorough project,” Benevy said. “We have an opportunity to do things right,” including taking steps to make sure the healthcare system is better prepared for future crises.