A survey of the provision of psychological treatments to older adults in the NHS

Abstract

Aims and MethodA questionnaire was sent to old age psychiatrists to ascertain their experience, views and clinical practice regarding psychological therapies in their services.ResultsThe provision of psychological treatments of all modalities to older people is widely varied in Britain. The main difficulty seems to be a lack of resources, but it would appear that inexperience with psychological therapies applied to older adults is also a factor. Most mental health teams (95%) provide anxiety management therapy, and cognitive–behavioural therapy is widely available (76% of teams), but areas such as training and staff supervision appear to be poorly provided.Clinical ImplicationsSuggestions are made to increase provision and quality of service within existing resources; improving services to the standards of the National Service Framework would be a bigger challenge.

Membership and management: structures of inter-professional working in community mental health teams for older people in England

“…Psychologists were also the least likely of all groups to be line-managed within CMHTs. The relatively poor access to psychological therapies by older people's teams raises concerns that this gap may be filled by other team members without the necessary training or supervision (Evans, 2004), or simply not provided at all. Furthermore, a recent survey of working-age adult CMHTs in England and Wales found a significant contraction in psychologist membership compared with data from the 1990s (Evans et al, 2012).…”

Elderly depressed patients: What are their views on treatment options?

“…A survey of general practitioners in the UK showed that 93% would consider referring elderly depressed for psychological help but only 44% had actually done so (Collins et al, 1997). Evans (2004) wrote that most old age psychiatrists in the UK would agree that older patients should have access to some kind of psychological services.…”

Old age mental health services in England: implementing the National Service Framework for Older People

“…Whilst recognising that the delivery of such ambitious goals would take time, the government emphasised the importance of early and systematic progress (Department of Health, 2001). Subsequent reviews made scant mention of the development of mental health services however, and acknowledged they needed attention (Department of Health, 2003, 2004, whilst other influential reports decried the lack of priority given to improving services for older people with mental health problems (Social Services Inspectorate, 2003;Commission for Health Improvements, 2003a, 2003b. This survey provides a detailed picture of the extent to which, some three years after its publication, old age mental health services were delivering the aspirations of the NSFOP (Department of Health, 2001) and gives some indication of the challenges that remain.…”