Developing Inclusive Mental Health Services for Older People
| Pages | 6-13 |
| DOI | https://doi.org/10.1108/13619322200100013 |
| Date | 01 June 2001 |
| Published date | 01 June 2001 |
| Author | Helen Bowers |
| Subject Matter | Health & social care |
Developing Inclusive Mental Health Services
for Older People
Helen Bowers
Director, Older People’s Programme,
Institute for Applied Health and Social Policy
Introduction
Older people (people aged 65 years and over) make
up a fifth of the UK population and this proportion is
growing. In 1996 there were 5000 people over 100
years old; by 2016 this number is predicted to rise to
over 20,000 – a four-fold increase in 20 years (Audit
Commission, 2000).
Many of these people do not need support from
health or social care services. In general the health
of older people is improving due to higher living
standards rather than advances in medical technology,
although this has played a part. Those who are
fortunate to have sufficient income, savings, and
their health lead active lives for much longer than
previously experienced (Leat, 1997).
This is to be celebrated, yet for many people
older age brings problems associated with poverty,
loneliness, stigma, and physical and mental ill health.
Older people use approximately half of all health
and social care services, and account for two-thirds
of emergency medical admissions to hospitals
(Department of Health, 2000a). Many of the
current government’s policies for health and social
care – and the broader inter-ministerial initiatives
such as Better Government for Older People – are
aimed at improving the quality of life for older people
and reducing inequalities in health. What older
people themselves want is the opportunity to live
independently, as full and active citizens in control
of their own lives (Harding, 1997).
Today, in 2001, there are still significant numbers
of older people who are disadvantaged through ill
health, inadequate services and the impact of previous
exclusive policies. Older people with mental health
problems are among the most vulnerable groups.
Considering the population figures quoted above and
the information now available about the prevalence
of mental health problems among older people, this
situation is unacceptable. One-fifth of people aged
over 85 years are likely to experience some form of
dementia and one-quarter of people over 65 years are
believed to suffer from depression. Until recently
this group had received relatively little in terms of
resources or a national policy direction.
This situation is changing, mainly due to the
impact of specific guidance such as No Secrets
(Department of Health, 1999b) and Forget Me Not
(Audit Commission, 2000), as well as general
guidance outlined later in this article. Advances in
clinical practice and specialist research programmes
undertaken by the Dementia Services Development
Centres (DSDCs) and the Mental Health Foundation
have helped to raise the profile of specialists caring
for older people with mental health problems. They
have also had a ‘lobbying’ role that has successfully
raised awareness about the range of mental health
needs that older people may have.
Health and social care organisations are now
required to demonstrate how they both identify and
respond to the needs of older people with mental
health problems, mainly through their Health
Improvement Programmes and Joint Investment
Plans (JIPs). Yet a recent (unpublished) study of JIPs
identified that older people as a whole, including
those with mental health problems, are rarely
identified as a separate group in terms of service
development and investment (Nuffield Institute for
Health, 1999). It follows that resources are rarely
targeted at this group while strategy development is
still in its infancy in most areas of the country. When
asked about health care provision, accessible primary
care is the most commonly expressed desire of older
people. Another issue is support for carers, both family
and friends. These are particularly important for older
people with mental health problems. The Audit
Commission’s report on mental health services for
older people, Forget Me Not, highlights not only the
6The Mental Health Review Volume 6 Issue 2 June 2001 ©Pavilion Publishing (Brighton) 2001
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