Are Mental Health Services letting down older people?
A mental health pandemic and an inadequate Government response mean that over 3.5
million older people who experience mental health problems do not have satisfactory
services and support, according to the final report from the UK Inquiry into Mental Health and
WellBeing in Later Life - a major independent inquiry supported by Age Concern.
The Inquiry makes 35 recommendations for ways to improve mental health services for older
people. It calls for action to: eliminate age discrimination in mental health; challenge stigma,
ageism and defeatism; work on preventing problems; support older people and their carers to
help themselves and each other; and improve housing, health and social care services. The
government must also provide leadership and overturn years of underfunding
in older people's mental health.
The Inquiry report reveals that mental health problems affect many more people in later life
than previously believed - and that the nature of the problems is wider than often
recognised. It reveals that up to 2.6 million older people - 1 in 4 people over 65 and 2 in 5
people over 85 - are suffering depression or serious symptoms of depression and one in five
people over 80 suffer dementia. It also highlights that older people with mental health
services are often ignored and receive little support services, and there exists a poor level of
services for people growing older with longstanding mental health problems such as
schizophrenia.
Women over 75 are more likely to take their own lives compared to any other age groups,
and men over 75 have the second highest suicide rates of all men in the UK.
Dr June Crown, Chairman of the Inquiry, said:
"Mental health problems in later life are not an inevitable part of ageing. They are often
preventable and treatable, and action to improve the lives of older people who experience
mental health difficulties is long overdue. Current services for older people with mental
health problems are inadequate in range, in quantity and in quality.
"The Inquiry has made 35 recommendations aimed at central Government, the NHS and
local government, commissioners, inspection and regulatory bodies, voluntary organisations,
higher education institutions and others. Our report draws attention to groups of older people
who are currently invisible in the UK, who have been denied the fair treatment that should be
a hallmark of a civilised society.
"We have no excuse for inaction, and no time to waste. We need a radical shift to improve
services and support for older people with mental health problems. At a time when the
Government is aiming to make the most of older people's contributions, the neglect of older
people's mental health needs represents a waste of human potential that we simply cannot
afford."
With the rising numbers of older people, the situation is set to deteriorate. Without a major
change in policy and practice, there will be 3.5 million older people with symptoms of
depression and nearly 1 million with dementia by 2021, and 5 million with depression and 1.7
million with dementia by 2051 - around twice the current numbers.
The report found that older peoples' mental health issues remain poorly understood, highly
stigmatised and are not given the priority necessary in policy, practice and research -
despite official reports since at least 2000 highlighting discrimination and calling for action.
Twothirds of older people with depression never even discuss it with their GPs, and of the
third that do discuss it, only half are diagnosed and treated. This means of those with
depression only 15 per cent or one in seven are diagnosed and receiving any kind of
treatment. Even when they are diagnosed, older people are less likely to be offered
treatment and the Inquiry has heard of GPs who have called depression a symptom of
growing older.
In 2006, a review of progress against the Government's National Service Framework for
Older people said that since 2001 explicit age discrimination had not declined in mental
health. To date, the Department of Health framework for mental health services has focused
only on people up to 65 - and people over that age receive different, lower cost and inferior
services to younger people - even if they have same condition. Many find they are moved
into 'older people's services', regardless of the suitability of these services, just because of
their birth date.
Gordon Lishman, Director General of Age Concern, said:
"The Inquiry's findings are unequivocal: years of ignorance, discrimination and underfunding
must be overturned. The Inquiry shows the true scale of the problems, but it also gives hope
for the future in the shape of practical steps that can help the millions of older people
suffering from a mental health problems.
"After four years of thorough research, we have a clear roadmap for what must be done next.
We challenge the government to learn the lessons of this report, and to take them forward."
Older people make a valuable contribution to the economy and these contributions are
growing in absolute and relative terms. By 2021, the unmet mental health needs of older
people will cost £230 billion per year in lost workers, £15 billion from the absence of older
carers, £5 billion from lost volunteers, £4bn from lost grandparents and £245 billion from lost
consumers.
The UK Inquiry into Mental Health and WellBeing in Later Life began in late 2003 out of
concern about the neglect of older people's mental health in policy, practice and research. It
is an independent inquiry supported by Age Concern. Today, it has published its final report,
which will set forward action points on the reform of mental health care for older people. The
report draws on a detailed review of literature and policy, a fieldwork study and other
evidence from older people, their carers, organisations and professionals.
Improving services and support for older people with mental health problems - The final
report from the UK Inquiry into Mental Health and WellBeing
into Later Life is available from www.mhilli.org