Mental health need
- Around 14% of older adults currently live with a mental illness (GHDx, 2023), some of whom will have developed this illness for the first time in older age (Raffertys, 2013). These illnesses should be seen within the wider context of healthy ageing, psychosocial needs, substance use, frailty and multimorbidity (Raffertys, 2013).
- The Royal College of Psychiatrists states that older adults have a similar prevalence of many mental illnesses as younger adults (The Royal College of Psychiatrists, 2018).
- Mental health is important to older adults’ quality of life and is closely related to physical health (Centre for Mental Health & Age UK, 2024).
Please use the buttons below to see pages on estimated prevalence in Cambridgeshire and Peterborough for mental health conditions and dementia:
Definitions
- Mental illnesses in older adults are often described as either being ‘organic’ (caused by a physical change in brain tissue, usually neurodegenerative conditions such as dementia) or ‘functional’ (including conditions such as depression, anxiety, and bipolar disorder) (Wells et al., 2020).
- The epidemiology and presentation of mental illness may be different in older adults than in younger adults, particularly as many older adults have multiple long-term conditions (The Royal College of Psychiatrists, 2018). We also recognise that older people may not define themselves as having a ‘mental illness’ and differences in how people describe these symptoms should be considered in communication campaigns (Independent Age, 2020).
- Some studies are likely to underestimate prevalence, as mental illnesses can be under-recognised in older adults and research often excludes people living in care homes. There are also some types of mental health need, such as self-harm (Isabela Troya et al., 2019) and complex emotional needs (Dykes et al., 2022), for which there is limited research in older populations.
Inequalities in service use
Research has consistently shown that there is a strong relationship between social disadvantage and poor mental health. This was detailed in chapter two of the mental health needs assessment. One way of assessing inequalities in terms of access to mental health services is to compare who is accessing mental health services compared to our local population. Understanding barriers is important to addressing inequalities. These graphs give a broad overview of inequalities in access to mental health services. However, it is also important to note that some variations may be due to differences in mental health need. Different groups are more likely to experience mental illness (NHS Digital, 2014), due to a complex range of biological, social and economic factors.
Age
The proportion of referrals from primary care to the Older People’s Mental Health (OPMH) Triage Hub was higher among 75- to 84-year-olds. However, the proportion of referrals to the other pathways was higher among the 70–79 age group.
Figure 27: Proportion of referrals by age group for OPMH services, CPFT, January 2021 – December 2023.
Gender
Women had a substantially higher number of referrals to OPMH compared to males, across all services. The higher female population in this age group is likely to contribute to this trend.
Figure 28: Proportion of referrals by gender for OPMH services, CPFT, January 2021 – December 2023.
Ethnicity
More than 80% of the referrals to the OPMH services were for people from ‘White’ ethnic groups. Between 12–15% of the referrals did not have any coding for the ethnic group.
Table 11: Proportion of referrals by ethnic group for OPMH services, CPFT, January 2021 – December 2023.
Deprivation
During the period between January 2021 and December 2023, less than 3% of referrals to the OPMH services were from the most deprived areas of Cambridgeshire and Peterborough. A higher proportion of referrals were from the least deprived areas.
Figure 29: Proportion of referrals by IMD decile for OPMH services, CPFT, January 2021 – December 2023.
Additional resources
- Epidemiology and mental illness in old age
- Royal College of Psychiatrists’ old age psychiatry training packs
- Older Adult Complex Emotional Needs: Recommendations for Services
- Our Invisible Addicts (2nd edition)
References
Full list of references is included at the end of this chapter.