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Elderly Mental Health 'Neglected'
BBC News
UK
October 9, 2005
Older people with mental illnesses face discrimination and poor services, a charity has warned.
A report by Mind says some people have to change specialists at 65, there can be a lack of choice over treatment and also age discrimination by GPs.
The charity says this is despite one in six people over 65 developing clinical depression and a third of suicides each year being among over 55s.
Government officials said they wanted to improve services for the elderly.
Mind released its survey of 489 people aged over 55 with mental health problems to mark World Mental Health Day.
It says the issue of mental illness in the elderly is increasingly important, because the population is ageing.
Susie Rabin, campaigns manager for Mind, said: "People do tend to assume that being depressed is part of being old - but they may be seriously depressed."
'Lack of choices'
Mind said the government's guidance on mental health care, the National Service Framework (NSF), only covers adults up to 65, so it has been left to the NSF for Older People to deal with mental health - but this document does not mention suicide, or come with ring-fenced funds.
Mind said this situation meant people's mental health needs had not been dealt with.
It said elderly people's problems accessing services were often down to how care was funded, because people become an "older person" instead of a "working-age adult".
This might mean people have to stop seeing the psychiatrist they have known for many years, and start seeing one who specialises in psychiatry for the elderly - which is likely to mean they focus on conditions such as dementia that are specific to that age group.
GPs are also less likely to consider the mental health needs of the elderly, said Mind.
Its survey suggested people over 75 are significantly less likely than the general population to be asked if they feel depressed or suicidal, or to be referred to a mental health specialist.
Elderly people are also reportedly not being offered a choice of treatments, particularly talking therapies.
Mind says waiting lists are long, and older people are seen as a lower priority for treatment such as psychotherapy, cognitive behavioural therapy, exercise or acupuncture.
They are also more likely to be prescribed the older type of antidepressants - tricyclics - rather than the more modern SSRIs (selective serotonin re-uptake inhibitors).
And double the rate of prescription of electro-convulsive therapy (ECT) - which has been linked to side effects such as memory loss - is seen in this age group.
Mind says there are added risks for older people, as they are more likely to suffer from heart complaints and other cardiovascular conditions that can cause complications during ECT.
Service 'tailored to need'
Richard Brook, chief executive of Mind, said: "Our report 'Access All Ages' highlights the shameful neglect of this vulnerable and often isolated group of people.
"The sudden removal of services and treatment at the age of 65 clearly causes great distress to many people - this unfair discrimination must be removed.
"Some GPs provide excellent support to older people, but too many health professionals do not yet receive the training to identify and deal with the growing mental health problems older people face.
"And it is crucial that for them, just like anyone else, treatment choice should be a right, not a gamble."
Professor Ian Philp, the government's national clinical director for older people, said: "We want older people to have the very best mental health services possible, which is why we want to improve the skill of staff in mainstream settings in mental healthcare and spread excellence for old age-related needs.
"I will be continuing to work with Professor Louis Appleby, the national clinical director for mental health, to ensure that access to services is on the basis of need, irrespective of age.
"We know that mental health services are improving and I want to ensure that older people benefit from those improvements."
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