Older People’s Mental
The Older People’s Mental Health (OPMH) Programme supports the delivery of the core clinical programmes within the Long Term Plan and the Mental Health Implementation Plan 2019/20 - 2023/24 (the Implementation Plan) by connecting commissioners, providers, professionals, patients and the public across pathways of care with the aim of improving health outcomes. This is achieved by sharing best practice and innovation, assessing and benchmarking quality and outcomes and driving improvement where required, through targeted support.
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We align with the Adult Mental Health Clinical Network programme on topics including all-age models, IAPT and Community Mental Health Transformation (CMHT) and with aspects of the Palliative and End of Life Care Clinical Network work programme. We also work closely with colleagues within the NHSE Regional Mental Health and Ageing Well Delivery Teams, OHID (Office for Health Improvement and Disparities) and Yorkshire and Humber Improvement Academy.
What We Are Trying To Achieve
The implementation of the Long Term Plan provides a unique opportunity to ensure consistent access to ‘functional’ mental health support for older adults and address the mental health needs of older adults wherever they may arise or present. Older adult’s mental health (OAMH) is embedded as a ‘silver thread’ across all of the adult mental health ambitions, including IAPT, community-based services for people with severe mental illnesses (SMI) and crisis and liaison mental health care. Delivery of the Mental Health aspects of the Long Term Plan must also demonstrate clear alignment with wider relevant Long Term Plan workstreams such as Ageing Well, primary care transformation, personalised care and learning disabilities.
To support delivery of older adults aspects of IAPT, CMH transformation work, crisis and liaison MH care to include:
- Improved access and treatment for older adults which aligns with local demographics
- Access to mental health support for older people which is based on needs and not age (e.g. physical and mental health co-morbid needs, cognitive issues and/or frailty or end of life care needs)
- Integrated service delivery which focuses on the person’s identified care and support needs across mental and physical health, social care and VCSE boundaries.
IAPT or Improving Access to Psychological Therapies are free to access NHS services that provide evidence-based psychological treatments for people with common problems such as depression and anxiety disorders. NHS England aims to increase the proportion of older adults who are benefitting from these services as currently access rates vary widely. The IAPT Older People’s Positive Practice guide (published May 2021) highlights changes that can be made across systems and within IAPT services to improve equity of access for older adults.
Why It’s Important
Mental health problems are as common in older adults as they are in younger adults and are associated with considerable individual suffering, suicide, higher use of health and social care services and poorer outcomes for physical illness (Mental Health in Older People: A Practice Primer).
Later in life, we are just as likely to experience common mental health problems and older adults have every right to expect health and social care professionals and services to respond to symptoms and signs of depression, low mood, anxiety and worry. However, mental health symptoms are far less likely to be volunteered, detected or treated in older people (Mental Health in Older People: A Practice Primer).
Older people have also been disproportionately impacted by the COVID pandemic and are reporting much higher than usual levels of mental distress. The proportion of older adults reporting symptoms of depression has doubled across the course of the pandemic (IAPT Positive Practice Guide, 2021). Age UK research shows that a third of older adults are feeling more anxious than before and that older adults are reporting feeling afraid to leave the house, becoming withdrawn, and losing confidence and motivation.
In addition, for some older people, services which are being provided by telephone or video may be inaccessible for people who do not have access to the internet or who lack the digital skills to use these tools (Digital inclusion in health and care). Older people should be provided with choice and supported to access services which work for them.
What We Have Achieved In The Last 6 Months:
- Established a Community of Practice focused on Community Mental Health Transformation for Older Adults
- In conjunction with OHID, published an infographic highlighting risk factors, triggers and presentations of Eating disorders in older adults.
- Published a case study highlighting the needs of an older adult with a history of disordered eating and considerations for care home staff when this person is admitted to residential care •
- Ran a half-day online event to share best practice to support improving access to IAPT for older adults (April 2022)
- In conjunction with Healthy London Partnership, ran a workshop to explore effective models of peer support for older adults with mental health problems (July 2022)
What We Plan To Do In The Next 6 Months:
- Continue to publish resources which highlight the mental health needs of older adults for referrers (in conjunction with colleagues from OHID).
- Deliver a series of webinars highlighting older adult needs, including Self-harm and suicide in older adults
- Work closely with Ageing Well colleagues to support alignment across the two programmes at strategic, system and place level.
- Liaison with other Clinical Networks, Commissioners and Providers across the country to learn from good practice models and intervention.
Helpful Resources and Links
- Mental Health in Older People: A Practice Primer
- Improving Access to Psychological Therapy (IAPT) Positive Practice Guide Older People (2021)
- Older People’s Mental Health Competency Framework
- Royal College of Psychiatrists Older People’s Mental Health Training Packs
- MindEd for Families - Mental Health advice for older people and those who care for them
Age UK The impact of COVID-19 on older people’s mental and physical health (July 2021)
Good Things Foundation Digital Inclusion in Health and Care (September 2020)