As Americans celebrated the contribution and sacrifice of veterans with speeches and marches across the country, a new study points to a hopeful new way of treating depression in former service members.
The therapy, Cognitive Behavioral Therapy for Depression (CBT-D), reduced levels of depression by about 40 percent in veterans of all ages, a Department of Veterans Affairs (VA) study released Monday found.
CBT differs from other forms of psychotherapy, the study's author says, because it focuses on specific ways patients can change modes of thinking to positively affect their mood and outlook.
For the study, researchers broke 864 veterans into two groups: 100 over 65 years old and 764 between the ages of 18 and 64. The researchers found marked reductions in depression in both groups.
But a troubling trend threatens to hamper the delivery of mental health services: older service members tend to avoid seeking out mental health counseling, both for cultural reasons and because their doctors mistake symptoms of depression as simply signs of aging.
"Primary care providers have been shown to be significantly less likely to refer their older than their younger patients for specialty mental health care," the authors write.
Brad Karlin, one of the study's authors, said on Oxford University Press' blog that older individuals in general view psychological therapy much more negatively than their younger peers.
Seniors are three times less likely to seek out psychological help, Karlin said. But, according to a 2011 VA study, 11 percent of older veterans suffer from major depression.
"Older individuals, particularly those born around or before 1940, often hold negative views toward mental illness and mental health treatment, due to differences in how mental illness was conceptualized and treated in the first half of the 20th century when they grew up," Karlin said.
"Many older adults also grew up in a time when self-resilience and getting through difficult circumstances on one's own was important and emphasized."
Karlin said current Medicare policy also restricts seniors' access to mental health care. Now, Americans over 65 can only get a 50 percent reimbursement from the program for mental health care costs, while they are reimbursed 80 percent of costs for other ailments.
But starting in January 2014, Medicare will start paying 80 percent (PDF) of mental health care costs for seniors.
Karlin hails this as a great opportunity to treat more seniors and train more doctors to recognize and respond to mental illness in the elderly.
"We are closer than we have ever been to bridging wide and enduring gaps in mental health treatment for older adults," Karlin told OUP.
Meanwhile, new rules compel insurance companies to treat mental illness in the same way as they would physical ailments.
As the military continues to grapple with a mental health crisis among service members and veterans, the nation honored those who have served and continue to serve for their country. President Barack Obama on Monday paid tribute to those who have served in the nation's military, including one of the nation's oldest veterans, 107-year-old Richard Overton.
"This is the life of one American veteran, living proud and strong in the land he helped keep free," Obama said during a ceremony at Arlington National Cemetery.
Overton rose slowly and stood to loud applause when Obama mentioned his name, then stood a second time at the president's request and drew more applause.
He was among hundreds attending the outdoor ceremony on a crisp, sun-splashed Veteran's Day. Earlier Monday, Overton and other veterans attended a breakfast at the White House.
Obama used his remarks to remind the nation that thousands of service members are still at war in Afghanistan. The war is expected to formally conclude at the end of next year, though the U.S. may keep a small footprint in the country.
Soon, "the longest war in America's history will end," Obama declared.
As the 12-year-old war draws down, Obama said the nation has a responsibility to ensure that the returning troops are the "best cared-for and best respected veterans in the world." The country's obligations to those who served "endure long after the battle ends," he said.
Al Jazeera and The Associated Press