Improving services and support for older people with mental health ...

Improving services and support for older people with mental health problems
Reducing the stigma of mental illness is a policy priority in all four nations, with national
anti-stigma programmes such as see me in Scotland, Shift in England and the new
Moving People initiative funded by the Big Lottery Fund and Comic Relief, also in
England. Public education programmes such as Mental Health First Aid, which teach
general members of the public to recognise the symptoms of mental health problems
and provide initial help, also help to reduce stigma.
To date, none of these initiatives have focused on older people. This needs to change,
because of the impact that stigma has on older people, because older people are
the fastest growing age group in the population, and because surveys consistently
show that older people hold negative attitudes about mental health. 207 Anti-stigma
initiatives should build on the work of the Alzheimer’s Society and Alzheimer Scotland in
promoting a better public understanding of dementia.
“There isn’t enough publicity that says what dementia is all about.
They don’t teach the public right. That is one thing that should be
publicised a lot.” 208
3.4 Other forms of discrimination
Older people with mental health problems are a diverse group and may experience
forms of discrimination in addition to ageism and stigma.
Racial discrimination is very relevant to mental health. Not only does it have a negative
effect on the mental health of individuals but there is evidence of racial discrimination
in mental health services. Some BME groups have higher than average rates of
compulsory admission, lower rates of GP referral, longer lengths of stay in inpatient
wards, 209 and are more likely to prescribed drugs or electroconvulsive therapy (ECT)
rather than psychotherapy or counselling. Racial discrimination fuels a ‘circle of fear’
that deters many from seeking early treatment for mental health problems. 210 Older
BME people say that being misdiagnosed and ‘labeled’ with a psychiatric condition can
impact on mental health in later life. 211 Race equality in mental health services is a policy
priority but more attention is needed to older people’s needs.
Gender differences are pronounced. At all ages, women are more likely than men
to have mental health problems such as depression and anxiety, and this continues
into later life where women outnumber men numerically. Women are more likely to
self-harm and misuse prescription drugs. Men are more likely to misuse alcohol and
die by suicide. Men are less likely to have strong social networks, making them more
vulnerable to isolation and depression in later life, for example after the loss of a spouse
or partner. Research suggests that targeted outreach is needed to ensure that older
men’s mental health needs are not ignored. 212 However, initiatives to promote gender
equality in mental health services have tended to focus on women, and paid little
attention to older people at all. 213
Older people with mental health problems may experience discrimination due to
disability (such as a learning disability or sensory impairment), sexual orientation or
religion and belief. Specialist services are often under-developed for these groups.
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