Concepts and issues in mental health and aging

The second and last prior edition of this book was published in 1992, seemingly a lifetime ago within the field of geriatric mental health research, and perhaps truly a lifetime ago for some readers. Over the 28 year span leading to the current version, the field of mental health and aging has experienced an unprecedented level of change and growth. The fundamental taxonomy of many mental health disorders has been questioned, adjusted, and redefined. The detection of biomarkers has taken a center stage in health care, and the conceptualization of mental health research within multidimensional constructs is a radical departure from dichotomous-based classification models for psychiatric disorders. Neuroimaging techniques have grown at an unprecedented rate. For example, the first publications on the technique of blood oxygen level-dependent imaging, vital in functional MRI, were released while the last edition of this book was in press. The role of mental health in whole-body well-being has gained traction, particularly as it applies to aging. The complex interplay of psychiatric symptoms, cognition, daily functioning, and aging is increasingly appreciated in medical care. Increasing thoughtfulness toward the importance of cultural competence, recognition of the impact of ethnic discrimination on mental health, and the integration of person-centered language into the lexicon of patient care are all relatively new, yet sorely needed changes within mental health care. The goal of the present chapter is to briefly synthesize the current state of the field and discuss the critical issues facing researchers and clinicians providing care to older adults.