Banerjee Debanjan, Rabheru Kiran, Ivbijaro Gabriel, de Mendonca Lima Carlos Augusto
Psychiatry, Private Practitioner, Kolkata, India.
University of Ottawa, International Longevity Centre (ILC), Ottawa, ON, Canada.
Front Psychiatry. 2021 Nov 12;12:774533. doi: 10.3389/fpsyt.2021.774533. eCollection 2021.
With a steady increase in population aging, the proportion of older people living with mental illness is on rise. This has a significant impact on their autonomy, rights, quality of life and functionality. The biomedical approach to mental healthcare has undergone a paradigm shift over the recent years to become more inclusive and rights-based. Dignity comprises of independence, social inclusion, justice, equality, respect and recognition of one's identity. It has both subjective and objective components and influences life-satisfaction, treatment response as well as compliance. The multi-dimensional framework of dignity forms the central anchor to person-centered mental healthcare for older adults. Mental health professionals are uniquely positioned to incorporate the strategies to promote dignity in their clinical care and research as well as advocate for related social/health policies based on a human rights approach. However, notwithstanding the growing body of research on the neurobiology of aging and old age mental health disorders, dignity-based mental healthcare is considered to be an abstract and hypothetical identity, often neglected in clinical practice. In this paper, we highlight the various components of dignity in older people, the impact of ageism and mental health interventions based on dignity, rights, respect, and equality (including dignity therapy). It hopes to serve as a framework for clinicians to incorporate dignity as a principle in mental health service delivery and research related to older people.
随着人口老龄化的稳步加剧,患有精神疾病的老年人比例正在上升。这对他们的自主性、权利、生活质量和功能产生了重大影响。近年来,精神卫生保健的生物医学方法经历了范式转变,变得更加包容且基于权利。尊严包括独立、社会包容、正义、平等、尊重和对个人身份的认可。它既有主观成分也有客观成分,并影响生活满意度、治疗反应以及依从性。尊严的多维度框架构成了老年人以人为主的精神卫生保健的核心支柱。精神卫生专业人员具有独特的地位,能够在其临床护理和研究中纳入促进尊严的策略,并基于人权方法倡导相关的社会/卫生政策。然而,尽管关于衰老神经生物学和老年精神健康障碍的研究越来越多,但基于尊严的精神卫生保健被认为是一种抽象且假设性的概念,在临床实践中常常被忽视。在本文中,我们强调了老年人尊严的各个组成部分、年龄歧视的影响以及基于尊严、权利、尊重和平等的精神卫生干预措施(包括尊严疗法)。希望它能为临床医生在与老年人相关的精神卫生服务提供和研究中将尊严作为一项原则纳入其中提供一个框架。