Diagnosing a mental health problem
The NHS England Practice Primer is a valuable resource for GPs which provides guidance on the diagnosis and management of common mental health problems in older people, highlighting differences in treatment compared to younger patients. It also offers tips on when to refer to secondary care.
MindEd is a free resource, which includes a section on older adult mental health.
Depression in older adults
The primary care management of depression in older adults is summarised in this 'Management of Depression in Older People:Why this is Important in Primary Care' document.
The MDTea podcasts presented by geriatricians Dr Preston and Dr Wilkinson include a podcast on depression in older adults, and accompanying education notes.
The RCGP e-learning offers a module on depression in older adults. About 20% of all suicides occur in older people, and suicide attempts in this age group are more likely to represent a true wish to die. The RCGP module on suicide prevention covers this in more detail.
Improving access to psychological therapies for older adults
Referral rates to psychological therapy of older patients with mental health problems have persistently lagged behind those of younger patients. A recent systematic review 'Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies' has sought to understand why.
The University of East Anglia offers a series of educational workbooks to help overcome the barriers to access for older people to psychological therapies. These booklets are primarily aimed at CBT therapists.
Discussing symptoms with patients
The Royal College of Psychiatrists has an excellent series of patient information leaflets. These are valuable to GPs to guide consultations. Topics of particular relevance to older adult mental health are depression in older adults, coping with physical symptoms, and medically unexplained symptoms.
Age UK has produced a 'Your mind matters: Ideas and tips for emotional wellbeing' booklet, which offers advice to older adults on strategies for improving their mental wellbeing. It also describes the mental health symptoms that should prompt a visit to the doctor, and includes some useful links to charitable organisations.
Patients at risk
Being a carer is a significant risk factor for ill health, both physical and mental. The ' A practical guide to healthy caring' for carers offers helpful advice on keeping well, taking breaks, as well as a list of contacts.
Having a long-term condition is a risk factor for depression. Parkinson’s disease in particular is associated with significant depression and anxiety. A recent parliamentary enquiry exposes the widespread unmet needs of patients with Parkinson’s disease, and calls for improved access to tailored psychological therapies. The survey reports that 75% of patients with Parkinson’s disease feel their mental health impacts on their quality of life. With this in mind, as GPs we can ensure we probe routinely into the mental health of our patients with Parkinson’s disease to establish whether treatment is required.
Resources for patients
10 Today. Physical inactivity is one of the key drivers of mental health challenges in later life. Conversely, physical activity can reduce the risk of depression and dementia by 30%. 10 Today is an exercise programme launched by a host of experts and led by older people, for older people. It provides a series of easy and accessible 10-minute broadcasts, which can be done almost anywhere and at any time, in a group or alone, standing up or sitting down, and which can be adapted to different fitness levels. 10 Today aims to increase mental wellbeing and social interaction through group classes, whilst also improving physical activity. Watch the workouts.
Policy documents: