Depressed Older Patients with Death Wishes: Experimental Evidence for Psychotherapists' Age and Health Bias

• Published in: Clinical gerontologist Vol. 44; no. 2; pp. 154 - 159
• Main Authors: Kessler, Eva-Marie, Grünewald, Lisa, Schäfer, Thomas
• Format: Journal Article
• Language: English
• Published: United States Routledge 15.03.2021; Taylor & Francis Ltd
• Subjects: Age; age discrimination; Ageism; Attitudes; Bias; Cognitive bias; Death & dying; Death attitudes; death ideation; depression; Discrimination; Health behavior; Health status; late-life suicide; Mental depression; Mental health; Mental health care; Mental health services; older adults; Older people; Optimism; Patients; Psychotherapists; Psychotherapy; Suicide; Therapists; Variants; Ageism; late-life suicide; mental health; older adults; depression; psychotherapy; death ideation; age discrimination
• ISSN: 0731-7115; 1545-2301
• DOI: 10.1080/07317115.2020.1856265

Objectives: When psychotherapists encounter an older patient with depression and death wishes, especially when burdened by physical illness, they may be subject to judgmental biases. This study investigates how this group of patients with highest suicide risk may experience discrimination both on age and health status. Methods: Using a 2 × 2 [chronological age x physical health status] vignette design, psychotherapists (N = 147) were randomly presented with one of the four variants of a case describing a patient with depression and death wishes (i.e., 78 years old + poor physical health; 78 years old + normal physical health; 48 years old + poor physical health; 48 years old + normal physical health). Afterward, participants' attitudes toward the case were assessed. Results: In case of the hypothetical patient's old age and poor health status, participants did not underestimate the pathological significance of his death wishes, but nevertheless showed less optimistic treatment attitudes and less confidence in psychotherapeutic treatment. Conclusions: Psychotherapists' age bias and health bias may serve as two potentially fatal factors influencing the provision of mental health services. Clinical Implications: Psychotherapists may contribute to better mental health-care provision of older adults with depression and the prevention of late-life suicide by increasing awareness of their age and health bias.