Mental health problems don’t end with age
- Mental health
Apr 10, 2019-
After years languishing in the dark, mental illness is finally getting its moment in the spotlight. Frustrating political football it may be, but one thing can’t be denied—it’s making headlines more than ever. Focus, largely, has been on young people—crises in child and adolescent mental healthcare and in student populations have been both persistent and significant. But mental illness doesn’t end with reaching adulthood—often, in fact, it doesn’t end at all.New research from the British Journal of Psychiatry into self-harm in older people puts this into stark perspective. A meta-analysis of 40 studies found that yearly self-harm rates were about 65 per 100,000 people, with risk of repetition and of suicide also higher than average. Self-harm is still seen as a problem among younger demographics; and while that remains true, this data proves that the issue is even more complex and diffuse than we thought.
The findings are not wholly surprising. In 2014, the World Health Organization found that suicide rates were highest in people aged over 70 in almost all regions of the world. The Royal College of Psychiatrists (RCP) also found that 40% of older people in GP clinics experience mental ill-health; this rose to 50% in general hospitals and 60% in care homes. And, as the Mental Health Foundation points out, the UK population is ageing rapidly—since 1974, the number of older people in the UK has grown by 47%. By 2027, the Office for National Statistics predicts, 20.7% of the UK population will be aged 65 or over,
compared with 15.9% in 2007. The problem, clearly, is not going away.
Combating loneliness is often seen as the key here—just this year, £11.5m was awarded to organisations designed to deal with the issue. But it isn’t enough. Loneliness is sometimes presented as the primary problem when it comes to tackling mental ill-health in older people—and, while it indubitably contributes, this explanation doesn’t really go far enough. Many of those experiencing self-harm, suicidal thoughts or other signs of mental distress already have diagnoses—they’re people who have dealt with mental illness their whole lives. Social isolation may contribute to their problems, yes, but it’s not the full picture.
In fact, as the Journal of Psychiatry research found, other factors are more important: age, history of self-harm, co-morbid physical conditions and pre-existing psychiatric diagnoses were all more significant than social isolation. Access to services—that perennial bugbear for mental health campaigners—rears its ugly head again here. As the RCP point out, 85% of older people with depression “receive no help from the NHS”; older people are also a fifth as likely as younger age groups to have access to talking therapies.
Some of this, of course, will be down to cuts to services. But it may also be down to how services are delivered. The NHS, in a primer intended to help general practitioners identify mental health problems in old people, points out that professionals risk attributing symptoms simply to “old age”. Older people are six times more likely than younger age groups to be put on medication by their GPs—but, with the research also showing higher prevalence of self-poisoning among older people, clearly there are potential ramifications to issuing prescriptions too.
And on a very basic level, acknowledging that mental illness is not a problem that suddenly vanishes as you age would be a huge step. The uptick in mental health discourse is great in many ways, but it isn’t always good at presenting a multiplicity of experiences. The current face of mental illness is young, white, middle-class, diagnosed with a condition such as depression or anxiety. People of colour, those with more serious diagnoses and the elderly are often not given a look in at all.
If we really are committed to fighting stigma, increasing provision of services and improving the lives of mentally ill people, we need to do better. Talking about mental illness more is not enough—we also have to think about what we’re saying, and to who.
Published: 10-04-2019 11:19