Assessing the mental health needs of older people

The National Service Framework for Older People


In 2001 the government issued the National Service Framework for Older People (NSF for Older People), which aims to:

Standard 7 relates to mental health in older people:

Older people who have mental health problems have access to integrated mental health services, provided by the NHS and councils to ensure effective diagnosis, treatment and support for them and their carers.(4)

(For more on the National Service Framework for Older people and the policy context, see Law and policy section).

There is also a National Service Framework for Mental Health (5), although this focuses mainly on adults of working age, rather than on the needs of older people experiencing mental health problems. The government recognises that more needs to be done to 'join up' mental health services and services for older people. Older people's mental health is often described as 'falling between two stools'. Older people with mental health problems face double discrimination: age discrimination and stigma about mental illness.

A national review of mental health services for older people in 2004 made this a priority within the Department of Health. In November 2005 the Department of Health issued a service development guide for integrated older people's mental health services called Everybody's business (6). This sets out the principles for a comprehensive older adult mental health service, and contains useful information and good practice advice for practitioners and commissioners of health and social care services. The key aim is to ensure that older adults with mental health problems and their carers have their needs met wherever they are in the system, without encountering discrimination or barriers to access.

The government's policy statement Securing better mental health for older adults (7) emphasises that while mental illness in older age is relatively common, it is frequently unrecognised, and even when it is diagnosed, the person does not always get the right help. Because mental illness in later life is quite common, and because it often coexists with other medical conditions, the majority of mild to moderately severe mental illness is treated in mainstream settings, by staff without psychiatric training.

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