The Royal College of Psychiatrists has updated
its guidance on caring for people who are growing older with an
existing mental illness.
When people with mental health problems grow
older, they may need to move between psychiatric services. For
example, they may move from general and community (or
rehabilitation) psychiatry to the psychiatry of old age.
However, making such transitions can be
difficult and worrying both for service users themselves, and for
their carers. Some people fear that their needs may not be met as
well in the new service, and that they may not have as much
influence over their own treatment. They may also be anxious about
facing stigma in older adult services, because these are often
perceived to be less well-resourced than services for younger
The new College report,
Links not boundaries: service transitions for people growing older
with enduring or relapsing mental illness, makes 20
separate recommendations to help improve the care of people during
this transition, including:
- Services should have agreed ‘transition
protocols’ which lay out the process for considering transition
between services. These should be drawn up locally with input from
service users, carers and local social services.
- The transition process should involve a
thorough assessment of the person’s needs.
- The assessment should be sensitive to the
person’s sexuality, spirituality, and cultural and ethnic
- It is best practice to consider transferring
a person when their mental state is stable.
- Copies of the transition protocol, written in
appropriate and accessible language, should be available to
everyone involved – especially the service users and carers.
- The transition process should incorporate the
users’ and carers’ views.
- A written copy of the agreed care plan should
(with the service user’s agreement) be shared with all relevant
professionals including their GP and any supporting
The report has been produced by a working
party including representatives from the College’s Faculties of Old
Age Psychiatry, General and Community Psychiatry, Rehabilitation
Psychiatry, the Faculty of Old Age Psychiatry consumer group and a
mental health nurse.
Organisations are advised to consider the new
recommendations, and to review their current procedures to help
improve the experiences of families using their services.
For further information, please
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CR153 Links not boundaries: service transitions for people growing older with enduring or relapsing mental illness
Note to editors:
Council Report 153 Links not boundaries: service transitions for people growing older with enduring or relapsing mental illness, updates Council Report 110 Caring for people who enter old age with enduring or relapsing mental illness (‘Graduates’)