Let's talk about...older people and mental health
Up until fairly recently, mental health problems in older people have tended to be pushed to one side, to be ignored even.
In my work as a counsellor I have always been curious as to why there hasn't been more attention and focus given to the mental health of older people and I suppose for that reason (and perhaps some others), I have been drawn to doing that very work. Outside of private practice, in 'ordinary' times my work sees me going into a care home to offer counselling to residents, staff and even family members of residents. I see and feel the results of this work and whilst clearly biased, strongly feel that this *should* be a service more easily accessible to all older people up and down the country, whether in care homes or not.
So the recent increased focus on mental health problems arising as a result of the pandemic has given me hope.
Let's be clear. Mental health problems don't end with age. Older people need help too. The Royal College of Psychiatrists found 40% of older people in GP clinics experience mental ill-health; 50% in general hospitals and 60% in care homes.
It is true that certain issues present themselves more than others in working with this unique group of clients - as you might expect, loneliness features high up on the list. But it is far from being the only concern that I see being brought into the therapy room. Like in my work with other clients, the issues are as diverse in nature as the clients are.
Alarmingly, research by the British Journal of Psychiatry found that yearly self-harm rates in older people were about 65 per 100,000 people, with risk of repetition. Suicide rates too are highest in people over the age of 70, according to 2014 research by the World Health Organization. Many of these individuals are people who have been living with mental illness their whole life, but, crucially, not all are.
Yes social isolation is a problem for this age group but there are many other factors too that impact mental health - fear of ageing tied to the fear of mortality; fear of loved ones dying; worries that surviving partners or children are properly provided for when they have gone. These kinds of fear manifest themselves as depression and anxiety. Yet despite this we know that 85% of older people with depression “receive no help from the NHS” (RCP) and older people are a fifth as likely as younger age groups to have access to talking therapies.
It is clear that as a society we need to do much better by our older people, not least because they are an ever increasing group within our society. By 2027, 20.7% of the UK population will be over the age of 65 (compared to 15.9% in 2007). Their needs cannot be ignored any longer.
We need to increase provision of talking therapies, not just medication, and make them more accessible to everyone who needs them, whether young or old.