TORONTO — Hope I die before I get old.
The Who gave the world this famous line in their 1965 rock anthem My Generation.
The sneering words, delivered by lead singer Roger Daltry, and the song remain icons for the baby boomer generation to this day.
Sadly, many of them may be destined to make it a self-fulfilling prophecy and in doing so unwittingly pose the question: when did living longer become a problem rather than a blessing?
Canadians 65 years and older, particularly men, may hold the answer. They have the highest suicide rate of any group in the country.
Approximately 33 out of every 100,000 individuals in that age range die by suicide in Canada annually.
And older, white males are the most likely to commit suicide, a benchmark 2005 study found.
The study noted specific risk factors: “... suicidal ideation or behaviour, mental illness, personality vulnerability, medical illness, losses and poor social supports, functional impairment, and low resiliency.”
In other words, seniors who live alone, who have lost spouses, friends, their health and perhaps some mental function, despair and are at risk.
Kimberley Wilson, executive director of the Canadian Coalition for Seniors’ Mental Health, says this is an increasingly familiar story.
Wilson says that while suicide is often associated with younger people, men over the age of 85 have — on average — higher suicide rates than all other age groups.
Although suicide death rates are lower among senior women, they have an overall higher rate of attempted suicide compared to senior men.
“Research consistently has shown high rates of suicide in the oldest age cohorts for men,” Wilson said.
“Plus, adults over the age of 65 use the most lethal means of self-harm.
“We also know that the baby boom generation is a group that has a high lifetime suicide rate. This statistic, coupled with the aging demographics in Canada, will likely mean a greater number of older lives lost to suicide in the future.”
Psychiatrist Dr. Paul Links is chief of psychiatry for St. Joseph’s Health Care in London, Ont., as well as serving as professor and chairman of the department of psychiatry at Western University.
He says predicting the future is a fraught business, but the prospective mental health of baby boomers needs to be discussed.
“There does seem to be some figures showing an increase in suicide rates amongst the elderly,” Dr. Links said, “and it should be addressed.
“I think you look at how society has changed, with many of the old support networks like family and church that once helped people stay connected to society are fragmenting.
“The baby boom cohort will be confronted by this and needs to be targeted amongst other groups. Those lacking strong social networks as well as family and other support networks can be most at risk.”
But there are already waiting lists for psychiatric and mental health services across the country, particularly for seniors.
And in many cases, seniors are reluctant to get help for issues like depression, and family members and even medical health professionals discount the moods and troubles of the elderly as part of being old.
Dr. Links points to family physicians and visiting health care workers as part of the chain of care that can help older adults in jeopardy.
He says they can be trained to see the links between serious mental illness, depression and suicide as part of a “collaborative care” approach.
“Identifying those at risk is the first step and we know some baby boomers have experienced high use of drugs and alcohol in the past. Now they feel hopelessness and anger on a scale that may lead them to suicidal options.”
Public policy discussion on right-to-die legislation, including a Quebec proposal to legalize medically assisted suicide, will no doubt increasingly become a part of Canada’s national dialogue on the elderly.
There is already ferocious debate on the issue, with medical opponents in that province arguing it opens a dangerous door.
But as the millions of boomers age over the next two decades, many will also grow increasingly isolated, sicker and develop mental health issues.
The demographic case is that some will contemplate or attempt suicide for reasons other than end-of-life health complications.
The Centre for Addiction and Medical Health (CAMH) has conducted research into the demographics of an aging Canadian population and the urgent need to improve the treatment of seniors with mental disorders.
Dr. Benoit Mulsant is CAMH’s physician-in-chief as well as the clinical director of the geriatric mental health program in the clinical research department.
He wants to start a conversation about mental illness and health care for seniors because they are not “disposable people” whose death by suicide can be dismissed more easily than the young.
“Serious mental illness seems to be the factor that plays a major role in causing men to take their lives as they age,” Mulsant said. “Some estimates put the rate at more 80% of suicides are due to serious mental illness.
“Cognitive impairment, schizophrenia and bipolar disorders are the main drivers of suicide. In the elderly we should not be afraid to talk about these things.
“Elderly suicide is somehow not seen as much as a concern as youth suicide because the public considers the victims are old. They didn’t have much life left to waste therefore society is less concerned.”