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NHS should consider offering longer GP appointments to older people with mental health problems, says report

by Awil Mohamoud
9 October 2020

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The NHS should consider introducing more flexible GP appointment lengths for specific patients with mental health problems, a national charity has urged, after its research found older patients are underrepresented in referrals for talking therapies. 

In its report on older people’s mental health, Independent Age said there was a need for ‘more options and support for those experiencing mental health issues in later life’.

It made a series of recommendations, including that the NHS ‘review the barriers to and the feasibility of’ increasing the flexibility of GP appointment lengths to give patients more time to discuss their mental health problems. 

The charity’s report pointed to the most recent data for the NHS’s Improving Access to Psychological Therapies (IAPT) programme, which shows people aged 65 and over make up just 6% of those receiving help. 

It said that this figure was ‘too low’ given the prevalence of mental health conditions in the community, and the fact that over 65s make up 18% of the population. 

As part of its report, Independent Age also carried out a poll of 2,316 people, which found that 46% of respondents aged 65 and over ‘were not aware of talking therapies’. 

The charity recommended that GPs and talking therapy commissioners in England do more to signpost older people to the IAPT programme, and called on the Government and CCGs to review the current barriers older people currently face when trying to access this service.

This includes developing ‘innovative actions’ to increase the number of older people receiving this treatment, it said.

The report also found that despite the low rates of referrals and poor awareness around the programme, people in later life often respond well to talking therapies, with data showing that people aged 65 and over had an overall recovery rate of 64%, compared to 50% for people aged 18-64.

But despite this, only 12% of people polled by the charity said they believe older people are given the support they need to manage their mental health. 

‘For many people, speaking to their GP was their first step. We heard about the importance of building up a relationship of trust with doctors, alongside the challenges of getting an appointment quickly and the frustration of only being offered limited treatment options,’ the report said. 

The charity added that while it had heard of ‘positive experiences’ from older patients around how cognitive behavioural therapy and counselling improved lives, feedback also pointed to ‘long waiting times and a lack of choice in the type of therapy offered’. 

Exacerbated by Covid-19

The majority of the research in the study was carried out before the pandemic but Independent Age also found that between March and July this year up to 98,000 older people experienced a partner bereavement – almost one and a half times as many as in a typical year.  

Deborah Alsina MBE, chief executive of Independent Age, said: ‘Now, more than ever, it’s critical that we take the mental health of people aged 65+ seriously. Even prior to Covid-19, people in later life regularly had to cope without their mental health needs being met, with 10% of people aged over 65 saying they experience significant anxiety or low mood frequently or all the time. 

‘Covid-19 has brought extra challenges around bereavement, but we’ve also seen an increase in mental health problems such as depression and anxiety – in fact, ONS statistics show that rates of depression have doubled for people aged over 70. This is an urgent problem.’

She added: ‘Conditions like depression and anxiety can affect people at any age – and people of all ages can be treated and recover. It’s vital that NHS England takes a multi-faceted approach to improving older people’s access to mental health services. We want them to review the barriers to accessing therapy, share best practice where it’s working well, and use targeted messaging to ensure people are aware of what services exist and how they can help.’