Mind exposes severe neglect of older people - Mind Cymru

Embargoed until:  00:01 Monday 10 October 2005

New research highlights cut-off of services, lack of treatment choice, age discrimination by GPs, lack of suicide prevention policy, high levels of ECT and diagnosis failure despite growing statistics.

"Ageism in my GP’s surgery is all too evident. I am dismissed as… too old to take seriously." 

"Too many people are unaware of any choices… many are told they are 'unsuitable' for talking therapies." Mind survey respondents

Today, World Mental Health Day, leading mental health charity Mind publishes a deeply disturbing report Access all ages *1 into older people’s experiences of mental health services. Key concerns are:

• cut-off of services available for 65s plus
• lack of treatment choice
• age discrimination by GPs, including lack of drugs information
• lack of any specific suicide prevention policy despite very high suicide rate: one third suicides committed by over 55s
• high prescription of electro-convulsive therapy: doubles for this age group.

The National Service Framework for Mental Health only deals with adults up to 65, so until the (currently draft) NSF for Older People (Wales) is finalised and fully implemented, there is no formal structure of approach to ensure that in Wales the mental health needs of older people are met sufficiently. Although the NSF for Older People will include a specific chapter on mental health, Mind Cymru hopes that the Assembly and service providers will learn from the problems experienced in England with full and meaningful implementation of their own NSF for Older People. There is currently a complete lack of mental health promotion activity for this group, and resource issues must be tackled now.

Access to services
Currently, when 65, the availability of many mental health services changes as you are classed as an 'older person' rather than a 'working age adult'. This is reflected in funding criteria, including Local Authorities, resulting in service providers having to operate age barriers on their services. Our research found that the general range and style of services being offered becomes much more restricted and the emphasis on mental health is lost*2.

High suicide rates
Older people over the age of 75 are only six per cent as likely to be asked about suicide by their GP, one fifth as likely to be asked if they feel depressed, and one third as likely to be referred to a mental health specialist.

Treatment choice
Survey respondents reported that a choice of treatments, particularly talking therapies, are often not available as waiting lists are long, and older people are seen as a lower priority for treatment such as psychotherapy, cognitive behavioural therapy, exercise or acupuncture. "I was not told about any treatments at all…except pills."  was a common complaint.

Drug treatments
Recent research backs up Mind’s ongoing campaign on the vital need for more information about drugs and their side effects – with particular impact on older people, given their greater lack of treatment choice. In our research, 38 per cent said that they were not given sufficient information about treatments and 40 per cent felt that they weren't adequately consulted about treatment options. In addition, a Royal Pharmaceutical Society survey showed that as many as 50 per cent of older people may not be taking their medicines as intended. They are also more likely to be prescribed an older tricyclic drug than a more modern SSRI, and recent analysis has shown that when a tricyclic is prescribed only 43 per cent of over 65s received an appropriate dose.

Electro-convulsive therapy (ECT)
A DoH survey (2002) showed that the use of ECT for over 65s was double any other age group, with no acceptable explanation. The controversial treatment’s serious side effects include memory loss, and 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.

Diagnosis failures despite growing statistics
It is of grave concern that despite the increase of mental health problems in old age, and increase of the older population, older people’s mental health problems are often not recognised by doctors and hospital staff and they are seldom seen by psychiatrists*3.  Latest figures show that 40 per cent of GP attendees, 50 per cent of general hospital patients and 60 per cent of care home residents are older people with mental health problems*4. One in six people develop clinical depression after they reach 65, 40 per cent of those in care homes. Dementia affects one in 20 people aged over 65 years, rising to one in five people over 80. In the next 10 years, the population of over 65s will increase by 15 per cent, and the population of over 85s by 27 per cent.

The campaign: Mind Cymru launch events today
Today's report launches a new Mind campaign. Access all ages demands that the National Assembly, Local Health Boards and GPs act together to ensure that older people have the same level and quality of support and treatment available to others.

Mind Cymru is holding two launch events, an art and creative writing competition is launched, and many of our local Mind associations are running activities throughout Wales to promote the campaign around World Mental Health Day.

Launch events:

• Llanishen Leisure Centre, Cardiff, 2.30 - 4.00. Guest speakers include John Griffiths, Deputy Health Minister with Ministerial responsibility for Older People
• Mold Town Hall, 10.30 - 3.00, also celebrating the work of Flintshire Mind and launching their new website.

*** Ends ***

1. Mind's survey Access all ages collates the views and experiences of 489 people with mental health problems over 50, conducted summer 2005.
2. Funding criteria has resulted in one LMA older service user only able to access facilities through role as a volunteer, and at another people over and under 65 have to be segregated.
3. WHO European Ministerial Conference on Mental Health (2005).
4. Department of Health (2005) Securing better mental health for older adults.