Positive Psychiatry: Reframing Mental Health Care Among Elderly

In 2020, 55.8 million Americans were 65 and over, representing 16.8% of the total population. Chronic conditions such as cancer, cardiovascular and chronic obstructive pulmonary disease, musculoskeletal disease, and metabolic disorder are prominent among the aging. Multiple factors such as declines in mobility, frailty, pain, and disability, together with a loss of independence, can indirectly contribute to changes in mood, increasing psychological distress, anxiety, and depression. Geropsychiatric clinicians should consider their approach to mental health care, taking into consideration life events, including loneliness, social isolation, and the loss of a significant other. Traditional psychiatry tends to focus on determining causative factors that contribute to mental illness while developing treatments that manage the problem. While effective, this approach often overlooks inherent traits that can bolster an individual’s resilience and stymie recovery. Positive psychiatry emphasizes an individual’s strengths, well-being, and optimal functioning rather than focusing solely on deficits like damaged habits, unconscious drives, or childhood traumas as causes of distress and neurocognitive dysfunction. This approach prioritizes recognizing and utilizing existing capacities to foster mental wellness. Mental health is viewed as a dynamic continuum, fluctuating between optimal well-being and significant distress based on life circumstances, personal experiences, and intrinsic and extrinsic factors. Positive psychiatry acknowledges this variability and explores how strengths like ambitions, positive experiences, and character strengths can empower individuals to navigate challenges and achieve greater well-being. This article discusses the benefits of reframing clinical approaches to the assessment and treatment of older adults who have a mental illness to incorporate the four components of positive psychiatry: [1] positive mental health outcomes, [2] positive psychosocial characteristics and environmental factors, [3] biology of positive psychiatry constructs, and [4] positive psychiatry interventions including preventative approaches. We offer insights and strategies to clinicians to integrate positive psychiatry into practice.