Long-term plan must end 'scandalous neglect' of over 65s

New figures from the royal college, shared with HSJ, showed the number of consultant old-age psychiatrists working in the NHS had fallen to 551 in 2018, down 12 per cent compared with 624 in 2014. 

The report also claimed evidence existed of both direct and indirect discrimination in mental health care against older people, adding this was not “legally justifiable”.

It noted the “failure of the Five Year Forward View to focus on the specific and distinct needs of older people sent a message that this was not an area that required resources or reform”.

The royal college also criticised the mental health workforce plan, published by Health Education England, saying it does little to address the differing needs of older people.

Amanda Thompsell, chair of the Faculty of Old Age Psychiatry at the RCP, said: “It’s scandalous that old-age mental health services have been neglected for so many years.

“We know that over 65s can really benefit when mental health services are tailored to their specific needs… The bitter irony is that some treatments – such as talking therapies – are most effective in over 65s, yet the stigma around mental health and fear of being thought less of by family and friends is deterring them from seeking help in the first place.”

The RCP also highlighted the findings of a YouGov survey of 2,000 adults, commissioned by Independent Age UK. This suggested people over 65 are less likely to admit to a mental illness compared to a physical one, due to fears they’ll be seen as incompetent.

The more severe the mental health condition, the more uncomfortable older respondents were about others knowing, the responses suggested.

George McNamara, director of policy and influencing at Independent Age, said: “Older people should be able to access mental health treatment and support at the same level as everyone else, but typically this is not the case…

“The forthcoming NHS 10-year plan is a prime opportunity to address the growing need for mental health services for an increasing older population.”

A spokeswoman for NHS England, said: “The message to anyone dealing with mental ill health is that help on the NHS is there for them. Nearly eight million people over 55 are affected by depression and anxiety, but their conditions often go unnoticed, so the NHS in England is helping doctors to spot and treat mental ill health among older people, and making effective talking therapies available across the country.”

A spokeswoman for Health Education England said whilst its mental health workforce plan did not make unique reference to the mental health needs of older age adults it outlined a starting point for work to be carried out on “upskilling the mental health workforce, rather than an exhustive list of work that would be undertaken.”

The statement added: ”It represents a starting point from which a number of pieces of work have now commenced and developed as we have enhanced our understanding and knowledge of the needs of both patients and the workforce.”

The Department of Health and Social Care were contacted for comment.

This story was updated at 14:02 with a comment from Health Education England.