One in five over-65’s living in the community is affected by depression but, despite Improving Access to Psychological Therapies (IAPT) services being open to all adults, older people are underrepresented amongst those accessing services. Psychological therapies are as effective for older people as for those of working age. Analysis of national data shows:
- The proportion of people over 65 year olds referred to IAPT services is lower than the proportion in the general population. Of people who use IAPT services over 65, most are under 75 and there are very few people over 90.
- Once referred, a greater proportion of older adults (42%) complete treatment than their working age counterparts (37%).
- Older people achieve good outcomes from IAPT treatment, sometimes better than people under 65. In 2014/15 56% of over-65’s showed reliable recovery after receiving psychological therapies compared with42% of working age adults.
There appear to be four main barriers to older people accessing IAPT services:
- Perception – In some cases older people may believe that psychological therapies are not relevant or helpful in addressing their problems – on occasion this may be a view supported by health and social care professionals who work alongside them.
- Practical barriers – Mobility and sensory problems that are more common in older people may require special consideration by IAPT services about the venue, timing and format of service delivery.
- Confidence – of IAPT staff, who can be less sure in working with older people.
- Exclusions – As IAPT was initially established to focus on working age adults in some services the needs of older people are not actively considered or sufficient efforts made to encourage increased access.
- NHS England and NHS Improvement have published A Practice Primer on Mental Health in Older People for colleagues in primary care, in particular GPs, which highlights symptoms often attributed to ‘old age’ but where a mental health diagnosis and follow-up is more appropriate. The publication is supported by the Royal College of GPs, the Royal College of Psychiatrists, the British Geriatrics Society and Age UK.
- For IAPT training resources for older people visit the University of East Anglia resources webpages for videos and guidance.
- The older people’s IAPT Positive practice guide provides best practice guidance to therapists and top tips on commissioning IAPT services for older people.