Article By: Charley Walker, News Editor
Mental illnesses, from anxiety and depression to OCD and bipolar disorder, affect one in four of the British population regardless of age but older people are often overlooked when it comes to discussions of mental health and wellbeing.
It is estimated that 85 per cent of the three million older people with depression receive no help from the NHS. Few are referred to talking therapies, despite showing better recovery rates than younger people who undergo this kind of therapy.
Nia Charpentier from Rethink Mental Illness said: “We do know that talking therapies can be very effective for this age group but 85 per cent of older people with depression receive no help from the NHS, and older people are a fifth as likely as younger age groups to have access to talking therapies.”
Depression affects seven per cent of the global population over the age of 60 years but is often underdiagnosed and undertreated in primary care settings. Symptoms may coincide with other problems associated with older adults and can therefore be disregarded.
This is all the more prevalent in older people suffering from anxiety. According to the Anxiety and Depression Association of America (ADAA), the condition is difficult to diagnose due to symptoms such as headaches, back pain and increased heartrate also being associated with physical illness, especially in older people.
Physical and mental health should be treated together
There is, however, a very real issue with treating both physical and mental illnesses in combination with each other, particularly in the UK.
A report published in October 2016 by the charity Age UK noted that, despite growing awareness that physical and mental health are interrelated, the NHS is failing when it comes to treating the two together.
According to the World Health Organisation (WHO), mental health has an impact on physical health and vice versa; older adults with physical health conditions have higher rates of depression, while untreated depression in older adults can negatively affect the outcome of a physical illness.
Age UK echoes this, stating in its report that failing to address mental and physical health together can seriously impact an older person’s recovery.
Yet in the UK, almost 40 per cent of mental health trusts have no policy for supporting comorbidities (the presence of more than one long-term condition) in people over the age of 65.
Elizabeth’s story
Detailed in Age UK’s report is the case of 88-year-old Elizabeth who, in her early 70s, was involved in a series of car crashes which left her anxious and feeling as though she could no longer get into town by herself.
As Elizabeth’s anxiety progressed, she became housebound and very lonely, yet was offered no psychological treatment; the anxiety was seen as a symptom of getting older and nothing more.
Elizabeth suffered a series of personal and medical incidents and while she received treatment for her physical symptoms, her mental health continued to be overlooked, which her family believes would not be the case had a younger person been in her position.
Cognitive decline and depression linked to loneliness
The World Health Organisation (WHO) highlights that mental health and emotional wellbeing are just as important in older age as they are at any other time of life.
The majority of the time, there are underlying causes as to why an older person may be feeling lonely or sad and often this is linked with poor mental health.
But, as illustrated in Elizabeth’s story, loneliness and sadness are feelings which many people of all ages consider to simply be part of getting older.
As a result, these feelings are often overlooked and not properly acknowledged and addressed.
According to Campaign to End Loneliness, loneliness puts individuals at a greater risk of cognitive decline and developing mental health illnesses such as depression.
‘Overwhelming sense of isolation’
Lucy Lyus, information manager at the mental health charity Mind said: “As we grow older we become more vulnerable to developing feelings of loneliness, and loneliness and mental health are linked – they can be both a cause and symptom of a mental health problem, such as depression and anxiety.
“Retirement, the death of a spouse and being less socially active can all contribute to an overwhelming sense of isolation
“Not being as physically able can make older people feel more vulnerable and in some cases make people feel more wary of going out alone.”
Nia Charptentier added: “We know that conditions like depression are prevalent in this group, particularly if you are recently bereaved or don’t have much contact with family or friends.
“Loneliness and sadness aren’t just a given at this age, and should be addressed and tackled.”
Mental health services need to ‘up their game’
To address the increasingly concerning issue of older people’s mental health, Age UK is calling on the NHS to improve mental health services for older people.
Caroline Abrahams, charity director at Age UK, said: “It is certainly time for our mental health services to up their game when it comes to helping older people, and we look to NHS England to provide the strongest possible lead.”
The ADAA says that older people are often reluctant to report symptoms of mental health problems because “they grew up in a time when mental illness was stigmatised.”
Ms Charpentier added: “This age group is often in regular contact with their doctor, and it’s really important that doctors and nurses keep an eye out for people’s mental health as well as their physical health, so that problems aren’t overlooked.”
“We can all do our bit to help. Being open about mental health can be an important first step.”
Retirement, the death of a spouse and being less socially active can all contribute to an overwhelming sense of isolation
“Not being as physically able can make older people feel more vulnerable and in some cases make people feel more wary of going out alone.”
Nia Charptentier added: “We know that conditions like depression are prevalent in this group, particularly if you are recently bereaved or don’t have much contact with family or friends.
“Loneliness and sadness aren’t just a given at this age, and should be addressed and tackled.”
Mental health services need to ‘up their game’
To address the increasingly concerning issue of older people’s mental health, Age UK is calling on the NHS to improve mental health services for older people.
Caroline Abrahams, charity director at Age UK, said: “It is certainly time for our mental health services to up their game when it comes to helping older people, and we look to NHS England to provide the strongest possible lead.”
The ADAA says that older people are often reluctant to report symptoms of mental health problems because “they grew up in a time when mental illness was stigmatised.”
Ms Charpentier added: “This age group is often in regular contact with their doctor, and it’s really important that doctors and nurses keep an eye out for people’s mental health as well as their physical health, so that problems aren’t overlooked.”
“We can all do our bit to help. Being open about mental health can be an important first step.”