Mental health articles

OF mental health care and mentally ill

Experiences of mental health services

For many people with dementia and/or depression and their families, the prospect of using formal services can be daunting. Too often, services for older people with mental health needs are criticised for being inflexible, impersonal, institutional in form and unable to provide continuity. Where good-quality services, resourced by skilled staff, do exist, these tend to be local and small in scale, and there is a need to share models of good practice more widely. There is also continued evidence of ageism in the provision of mental health services with services for adults up to the age of 65 (adults of working age) configured separately to those for adults aged 65 and over (older people). Furthermore, a recent review suggested that those for older people are inferior. There are also problems of access to mental health services in residential care settings; for example, research in care homes suggests that depression is often undiagnosed and treatments under-utilised.

The mental health needs of older people from black and minority ethnic communities have been particularly neglected. We know that there are lower levels of awareness of conditions such as depression and dementia within these groups and that older people and their families from black and minority ethnic communities have problems accessing help from services. There is insufficient evidence to date on whether integrated or separate services are more effective, but the need for more culturally appropriate and sensitive services is clear. Research carried out by the Policy Research Institute on Ageing and Ethnicity found that a lack of knowledge about services, language difficulties and the expectation on behalf of service providers that elders from black and minority ethnic groups will ‘look after their own’ are particular barriers to effective care.

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