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The epidemiology and presentation of mental illness in older people is different to younger adults, and older people with mental illness often have a unique and complex set of physical, psychological and social factors complicating their care. For these reasons older people need dedicated inpatient and community mental health teams to look after them.
There is a global history of ageism in the funding and delivery of mental health services for older people. The UK has led the way in developing age-specific services which research has shown improve care in this group. These services are now under threat in the UK by the move to "ageless services". Commissioners and trusts have various reasons to consider this including a misguided belief it may save money or misinterpretation of the Equalities Acts around the UK.
The College is clear that older people need dedicated age-specific mental health services. We have assembled a compendium of evidence to support this below.
If your services are under threat, please look at and use this evidence. Many people have already found it helpful to rebut the move to ageless services.
- 'Ageless' dementia services are an insult to the elderly - The Telegraph
- Development of ageless mental health services - letter
- Criteria for Old Age psychiatry services in the UK
- IPG guest editorial: Wither old age psychiatry?
- JCPMH: Guidance for commissioners of older people’s mental health services
- Letter in The Lancet: Psychiatry for the elderly in the UK
- IJGP letter: Redefining old age psychiatry - a pragmatic approach
- The Times Letter to the Editor: Mental health and how the other half lives
- RCPsych letter to Jeremy Hunt - Ageless services
- BJPsych editorial: Old age psychiatry in the modern age
- JGCR: Ageless mental health services and the future of old age psychiatry in the UK.
- Nilforooshan R et al (2016) Comparison of service utilisation and costs of working age adults and older adults receiving treatment for psychosis and severe non‐psychotic conditions in England: implications for commissioning. International Journal of Geriatric Psychiatry, 32:110-115.
- Abdul-Hamid WK, Lewis-Cole K, Holloway F, Silverman AM. Comparison of how old age psychiatry and general adult psychiatry services meet the needs of elderly people with functional mental illness: cross-sectional survey. Br J Psychiatry 2015; 207: 440–3.
Please give us any feedback as to whether these resources help or not in your fight to preserve your services.
- CR221: Suffering in silence: age inequality in older people’s mental health care (pdf)
- CR217: Young-onset dementia in mental health services (pdf)
- CR211: Our Invisible Addicts (pdf)
- The integration of care and its impact on older people's mental health FR/OA/05 (PDF)
- Criteria for old age psychiatry services in the UK FR/OA/04 (PDF)
- Guidance for job planning FR/OA/03 (PDF)
- Depression in care homes - joint report with the BGS 2018 (PDF)
- Careers leaflet for Foundation Doctors 2018 (PDF)
- Outcomes in older people's mental health service November 2017
Faculty documents and submissions
- Read our 10 recommendations for working with older adults launched at our 2018 International Congress
- Read our submission about the Five Year Forward View to the APPG for Mental Health.
Survey of services results
- See best practice guidance for commissioners and carers. For more information visit the dementia section of the NHS London Clinical Networks website
- Guidance on Neuroimaging for dementia
- Streamlining Memory Service Pathways
- Commissioners’ checklist for dementia
- Guidance on the content of delirium policies
- Guidance on managing pain for people with dementia
- Guidance on using a recognition scheme
- Guide to dementia training for health and social care staff
- Immediate post diagnosis support guide.
- The Young Onset Dementia Pathway gives recommendations for commissioners and practitioners to create the ideal care pathway. It was developed by people affected by young onset dementia and the people who work with and support them
- National Collaborating Centre for Mental Health Dementia Care Pathway full implementation guidance.
- Guidelines for the peri-operative care of people with dementia (Wiley Online Library)
- Driving with Dementia or Mild Cognitive Impairment Consensus Guidelines, by Newcastle University and endorsed by the College (2018)
- Hidden in plain sight, by Age UK, examines the unmet mental health needs of older people.
- MindEd is a new educational resource that has been co-produced with older people. It explains a range of mental illnesses/concerns and offers practical advice for dealing with them.
- NHS England's Mental Health in Older People Practice Primer helps improve recognition of mental health issues in older people.
- Physical health drugs start-stop reminder card (Word)
- Brain Health and Mental Well-Being: GCBH Recommendations on Feeling Good and Functioning Well (PDF)
Delirium Awareness Video #ICanPreventDelirium
As part of the #ICanPreventDelirium campaign, faculty members Dr Krishnan and Dr Bennett, in collaboration with Teesside local councils and CCG produced this video with the aim of improving recognition and management of delirium in any healthcare setting.
Depression in older people
This video explores the symptoms of depression in older people and what help you can get if you are feeling depressed. It also shows how to cope if you are a friend or family member of an older person suffering from depression.