Working with midlife patients in mental health

Midlife (around 35-to-55) is often thought of as a period of ‘settling down’, but this stage can in fact present some of life’s biggest challenges.  

It’s a time when many major life events can intersect. This increase in stress can lead to a higher incidence of mental health issues, such as anxiety. 

But mental health awareness is growing, and so are the avenues of support for midlife mental health. If you want to help people overcome challenges and thrive, upskilling in midlife mental health could be an ideal career step for you. 

Mental health in Australian adults

Midlife often comes with significant changes. Big life events like purchasing property, starting a family or pursuing higher levels in one’s career are important, but often stressful milestones. In fact, research shows transitions in life can often lead to, or exacerbate, mental health conditions.  

As midlife continues, transitions can become even more challenging, as experiences such as ‘empty nesting’, caring for elderly relatives and divorce are common. Add to this the biological changes of ageing such as weight gain, hair loss and menopause, and we can begin to understand why mental conditions for this age group are on the rise.  

Conditions such as anxiety and depression are increasingly common, with 45-to-54-year-olds representing the second-highest proportion of mental or behavioural conditions in the National Health Survey 2017–2018. And for women, hormonal changes associated with perimenopause and menopause can lead to a greater risk of depression.

The unique pressures of modern life provide fertile ground for emerging mental health challenges. Global events of the past few years have put further pressure on mental health, with natural disasters, international conflict, and the ongoing COVID-19 pandemic only serving to increase the prevalence of mental health conditions.  

In 2021, Australia’s Mental Health Think Tank reported a ‘population-level deterioration in mental health’. This was evidenced by higher rates of anxiety and depression and increased use of suicide and support helplines. They also found evidence that lockdown and restrictions may have led to increased alcohol consumption, particularly for those in the midlife age group. 

Climate change is another contributing factor to rising stress levels. In fact, data shows Australians are three times more worried about climate change than COVID-19, with 35-to-54-year-olds among the most concerned.

Mental health in families and society

While mental health can be considered a highly personal topic, its impacts are felt right across society in both families and the wider community. Increased rates of substance abuse and domestic violence are common, and research shows that children whose parents had experienced psychological distress were more likely to experience their own social-emotional difficulties.

According to Beyond Blue, over 20 per cent of Australians have taken time off work in the past 12 months because of stress, anxiety or depression. But the impacts of poor mental health are perhaps most severe within the family unit, where midlife adults are often breadwinners and carers for children and other relatives.  

For business owners in particular, financial stress can have a direct and destructive impact on relationships. Suzanne Schultz, a psychologist, business owner and leadership training professional, recently worked with a female business owner who looked highly successful from the outside but was experiencing financial anxiety behind closed doors. 

“[My client] was running the business side of things… when they needed overdraft facilities, they were drawing onto their home. She was really frightened to talk to her husband about money. She felt responsible and at risk and really quite anxious. She couldn't sleep.” 

As mental health problems often lead to decreased working hours, more frequent relationship conflict, and increased substance use, the whole family experiences social and financial stress. 

Research also shows that children who are exposed to parental stress, anxiety and depression are not only more likely to experience their own mental health issues, but are also at a higher risk of learning and behavioural problems and reduced economic mobility later in life. 

Where midlife Australians are seeking help

Better awareness of mental health means we’re seeing individuals showing a greater understanding of their own needs. Early findings from the upcoming National Study of Mental Health and Wellbeing 2020 to 2021 reveal that 61 per cent of Australians took considered action to manage their mental health during the survey period. Activities included increasing physical activity, practising positive thinking, and doing more things they enjoy.  

For some people, speaking to a psychologist is the best way forward. For example, Ms Schultz was able to offer her business owner client practical steps to manage her financial anxiety. 

“It was really useful to have a conversation with her about distancing and detaching from money and seeing it as something that they were using in order to deliver an effective business. Also, increasing her financial skills in order to decrease their anxiety and fear.” 

But it’s not only qualified psychologists who can offer support. As more than 80 per cent of Australians between 25 and 54 are employed, the workplace provides an important setting for mental health intervention. Initiatives like Employee Assistance Programs (EAPs) give employees access to counselling and support for both professional and personal issues. 

Ms Schultz has worked with a number of organisations that are focusing on the psychological wellness of their employees. 

“The kinds of things that organisations are doing include giving managers and leaders and employees the opportunity to study mental health first aid. That means your ability to look out for and help people to find the resources that they need when they're not okay,” she says. “There have also been organisational initiatives related to R U OK? Day, wellness programs in workplaces, opportunities for meditation, for exercise, for connectedness across people, so that people feel part of a team and part of an organisation.” 

Technology provides important platforms for people seeking mental health support. The Australian Government launched the National Mental Health and Wellbeing Pandemic Response Plan in 2020 alongside $48.1 million in funding to monitor and respond to the mental health needs of Australians. Part of this plan is to expand access to mental health support through digital and telehealth services, which are now taking root in the mental health ecosystem.  

These days, it’s not only possible to see a therapist via online or telephone appointment, but also via self-service. On-demand apps such as Headspace, Smiling Mind and Calm are also popular alternatives for many adults who may not have otherwise sought mental health treatment.  

Specialising in midlife mental health

Of course, all this attention and innovation in the field means mental health services are increasingly in demand. Ms Schultz says opportunities are available in a range of different fields, and don’t need to involve a psychology qualification. 

“In my experience, lots of people are interested in counselling and supporting other people. There are all kinds of study that people can do – you can become a social worker, you can do a Graduate Diploma in Counselling… those kinds of qualifications will enable you to support programs like EAPs and not-for-profit organisations working in mental health, where there’s a demand for people who have interest, skills and the kind of attitude that is required to support people in the community.” 

Given that the workplace is such an important setting for midlife adults, there are also opportunities for leaders and human resources professionals to grow their skills in mental health. Ms Schultz says providing the right support is good for both employees and the organisation. 

“For example, performance management done poorly can really affect people's confidence and their ability to be successful at work. So, when managers have the skills and knowledge to effectively use performance management to support people to succeed, then that's good for everybody in the organisation.” 

Working with adults in midlife means working with people across a broad age range and creates opportunities for learning across a number of areas. For example, you may choose to work with people who are facing peri- or post-natal depression, those with substance abuse problems, or provide more generalised support as clients navigate the challenges of midlife.  

The skills you’ll need are consistent across the whole mental health profession, including good judgement, critical thinking, empathy and understanding, and highly developed communication skills. You’ll also need to be comfortable to quickly develop trust and rapport with patients, creating a safe environment for them to work through their problems.  

Fortunately, many of these skills are transferable and you may already possess the building blocks to become a great mental health professional. Nurses, counsellors and other health workers are likely to find specialising in adult mental health an efficient and rewarding transition in their career.  

And if you already work with midlife adults in some capacity – for example, as a human resources professional – you may be well placed to specialise in midlife mental health.

Opportunities to develop your career in mental health

Our courses are designed to combine a comprehensive education with the benefits that come with learning online.  

Postgraduate study is a highly personal choice. Need more information? Take a look at degrees in psychology, mental health and counselling to find the right course to transform your career. 

• Sources
• VeryWellMind: Finding Ease With Transition in Ever Changing Times
• Australian Institute of Health and Welfare: Mental health: prevalence and impact
• Jean Hailes: Looking after yourself 
• Australia’s Mental Health Think Tank: COVID-19 and Australia’s Mental Health 
• The Conversation: Australians are 3 times more worried about climate change than COVID. A mental health crisis is looming
• Emerging Minds: Parental mental health and parenting: How are they related?
• Beyond Blue: Statistics
• Better Health Channel: Relationships, family and mental health
• Substance Abuse and Mental Health Services Administration: Mental Health and Substance Use Co-Occurring Disorders  
• National Mental Health Commission: Pandemic Response Plan