Ageing with a serious mental illness: a literature and policy review
| Published date | 21 June 2013 |
| Date | 21 June 2013 |
| Pages | 65-72 |
| DOI | https://doi.org/10.1108/MHRJ-12-2012-0033 |
| Author | Andrew Clifton,Gwen Marples,Amanda Clarke |
| Subject Matter | Health & social care |
Ageing with a serious mental illness:
a literature and policy review
Andrew Clifton, Gwen Marples and Amanda Clarke
Andrew Clifton is a Senior
Lecturer in Mental Health
Nursing, Gwen Marples is a
Senior Research Associate
and Amanda Clarke is
Professor of Nursing, all at
Northumbria University,
Newcastle, UK.
Abstract
Purpose – With population projections indicating that the number of older adults in the UK (those aged 65
years and over) will increase from 9.6 million in 2005 to 12.7 million in 2021, the numbers of those growing
older with a serious mental illness (SMI) is likely to rise. Currently there is a lacuna of both policy and quality
research evidence on how to meet the needs of this vulnerable group of citizens. The purpose of this paper
is to add to the emerging debate and discourse around current policy and practice in this field.
Design/methodology/approach – The authors have undertaken a general review of both the literature
and current UK policy guidance to determine the current state of provision for people with a SMI.
Findings – Much of the relevant literature the authors identified originates from the USA, with older adults
with SMI perceived as an under-served population in need of urgent attention. Additionally, UK policy
provision is patchy with very limited pockets of good practice currently available to guide clinicians and
inform service users.
Research limitations/implications – Clinicians, researchers and other stakeholders must engage with
service users, their family and/or friends to produce quality and meaningful research to improve outcomes
for this vulnerable group of citizens. Finally, the policy, practice and service user communities need to
collaborate in a spirit of “boundary spanning”working across disciplines to generate practical policies which
can be operationalised by organisations and individuals.
Originality/value – This paper highlights the distinct lack of literature, evidence and policy which currently
exists in the UK addressing the needs of older adults with a serious mental illness.
Keywords Ageing, Serious mental illness, Policy, Practice, Boundary spanning, Elderly people, Elder care
Paper type General review
Introduction
A definition of serious mental illness (SMI) with a wide consensus is that of the National
Institute of Mental Health (NIMH) (Schinnar et al., 1990) and is based on diagnosis, duration and
disability (National Institute of Mental Health (NIMH), 1987). People with SMI have conditions
such as schizophrenia or bipolar disorder, over a protracted period of time, resulting in erosion
of functioning in everyday life (Tosh et al., 2011). People with SMI have a higher morbidity and
mortality from chronic diseases than the general population, resulting in a significantly reduced
life expectancy (Robson and Gray, 2007). With population projections indicating that the
number of older adults in the UK (those aged 65 years and over) will increase from 9.6 million in
2005 to 12.7 million in 2021, the numbers of those growing older with SMI is likely to rise.
Godfrey (2005) highlight the “layers of invisibility” that older adults with SMI face, suggesting that
they are the “most complex, vulnerable, resource poor and high risk long-term service users in
society today”.In this discussion the policies we refer to relate to health policy in England, unless
otherwise stated and the term “older adults” refer to those aged 65 and over, however, we
acknowledge in other parts of the UK, for example, Scotland, the picture is somewhat different
as the term “adult” refers to all adults aged 18 years and over.
DOI 10.1108/MHRJ-12-2012-0033 VOL. 18 NO. 2 2013, pp. 65-72, CEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTH REVIEW JOURNAL
j
PAGE 65
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