Large numbers of older people could do with some mental health support - but are less likely than younger groups to receive it

During this year’s Mental Health Week Age UK is drawing attention to the fact that older people are just as likely to be living with depression and anxiety as younger age groups, but are much less likely to be receiving the support they need.

In 2020/21 just 5% of referrals to NHS talking therapies were people over 65[i], significantly below the 12% hoped for and expected [ii]. The pandemic didn’t help of course, but in fact the proportion  had already been declining for the previous two years before COVID-19 arrived. 

Many older people find it very difficult to discuss their mental health but there is still a significant need. According to the latest data extracted by Age UK[iii], of people over 65:

• Over half a million (579,803) experience anxiety disorder
• Just under half a million (487,100) experience a major depressive disorder
• Just under 200,000 (191,740) experience chronic depressive disorder
• And over 140,000 (140,332) experience bipolar disorder.

It is also notable that a larger proportion of woman aged 65+ experience these difficulties than men. This is particularly the case among those reporting anxiety disorders, where nearly double the number of women are impacted compared to men.   

Caroline Abrahams, Age UK’s Charity Director, said: “Only some of us will experience a mental health condition, but most of us can feel depressed and lonely at some point in our lives. As we get older, we can also become especially vulnerable to factors that lead to depression such as bereavement, physical disability, illness and loneliness.

“The pandemic has hit older people particularly hard, making many of these risk factors unavoidable during their daily lives over the last two years. In fact though, depression isn’t a natural part of ageing, but older people often don’t seek help for their mental wellbeing and so they miss out on treatments that are available to them on the NHS. It is vital they get the help and support they need and talking therapies could make a huge difference to them. Older people shouldn’t be afraid to raise any mental health concerns with their GP.

“Mental health impacts on the physical health of older people and vice versa. For example, older adults with physical health conditions such as heart disease have higher rates of depression than those who are healthy. In addition, untreated depression in an older person with heart disease can negatively affect its outcome[iv], making it all the more important that anyone struggling with a mental health problem speaks out and asks for the help they need.”

“The pandemic has had a big impact on us all and very few of us are emerging from it totally unscathed. We know that many older people may feel reluctant to start a conversation about their mental health with their GP, but NHS treatments such as counselling are just as effective in older people as they are with other age groups. There is a commitment by NHS England to increase overall access to talking therapies, but older people seem to be continually missing out. For this reason we think that there should be a specific target for older people; without it the chances are the trend will continue to move in the wrong direction, with even fewer older people being enabled to access talking therapies than there are now. 

Peter Ireland, Counselling Manager for Age UK Manchester, said: “We’ve known throughout the pandemic that there was a lot of unmet need for mental health support. Services were reduced and people were told to stay at home. Whilst this will have reduced a person’s risk of getting Covid, it will have undoubtably have increased feelings of loneliness, isolation, stress and worsening or sometimes new mental health concerns. As a result, levels of anxiety have increased with increased numbers of people struggling with social anxiety and even agoraphobic tendencies. There is also an increase in the need for bereavement counselling, with grief being complicated by people not being able to be with loved ones when they died and, in some cases, not being able to attend their funerals.

“This level of need has led to a sort of ‘ticking time bomb’ for mental health support and we are now starting to see that come home to roost. In March, for example, our Counselling Service provided more counselling hours than it has in any other time since its creation more than 25 years ago.”

In Age UK’s most recent survey of older people on the impact of Covid (April 22) we heard many comments like these:

‘I have felt extremely lonely for the first time in my life as I have taken shielding very seriously. I have been at home, only leaving for medical appointments. My anxiety is sky high.’

‘There are days when i don’t want to be here anymore as my quality of life is so bad with psoriasis, depression, Chronic obstructive pulmonary disease (COPD) and little health care interest, [while] on top of that money worries…’

‘Isolating is very debilitating mentally, very little human contact is hard to deal with.’

‘Anxiety and stress levels are higher. Depression and paranoia have been affecting me and my family relationships.’

‘I'm more depressed, prefer my own company, got used to not seeing family. Seem to have lost confidence outside the home. I'm working on it. It takes effort.’

‘The pandemic has had an effect on my whole life and if the pandemic hadn’t happened, I would still have been able to get enjoyment out of life despite my health problems and would have been able to cope with my problems more easily.’

Self-help tips for older people

More optimistically, there are lots of other things we can all do that can boost our mood and help us to connect with others. Even if we don’t feel particularly motivated to do them at first, if we give them a go we may find that the benefits give us the motivation to keep going.

Talk about your feelings
If you notice changes to your thoughts, feelings and behaviours that are affecting your daily life, last longer than two weeks, or keep returning – try to talk to someone you trust, ideally your GP who can signpost you to support. Talking to friends and family you trust is a great way to relive old memories and remind you of all the positive things in your life. When you feel depressed and isolated it can be tempting to think nobody would want to hear from you but often, you'll find people really are pleased if you get in touch and are only too happy to help.

Make new connections
Spending time with other people can prevent you from feeling lonely or anxious and give you a chance to share experiences, thoughts and ideas.

• You might want to consider joining a friendship group. This can be a good way to build new and meaningful friendships, and help you to regain your confidence.
• You might want to be around people you have more in common with. Contact your local Age UK to find out what social activities they offer. They often have unique clubs and classes you can take part in. These can be great in helping you to build and maintain social connections but also are a great way to learn a new skill or revisit an old hobby. 
• If you're missing the social connections you used to have through work, you could also consider volunteering or perhaps going to classes through The University of the Third Age.

Friendship services
There are some services that help people to connect who feel down and isolated. If you like having a chat there are a number of services that could match you with someone to talk to, including:

• Age UK's Telephone Friendship Service allows you to sign up for a free weekly friendship call. It can be a great way to get to know someone new.  
• You can also ring The Silverline, 24 hours a day. This is a free service for older people who looking to have a chat with a friendly and supportive volunteer.
• Many local age UKs offer face-to-face befriending services. These often involve a volunteer visiting someone at home for a cup of tea and a chat, or going out together to enjoy a shared interest.

Be kind to yourself
It’s important to have a treat from time to time and do the things that bring you joy. Try to find time for the activities you enjoy, whether that’s cooking or going out for lunch with friends. Or simply take some time by yourself to sit down with a good book.

Get enough sleep
Sleep patterns change as we get older and lack of sleep can directly affect the way we feel. If you’re having difficulty sleeping, try cutting back on daytime naps and reduce the amount of caffeine you drink. See if you can make time to relax and unwind each evening, perhaps by reading a book, listening to the radio, or having a bath.  

Eat well and drink sensibly
What we eat and drink affects how we feel. Rising prices are a problem, but do what you can to avoid filling up on the wrong things. Also, don’t ignore any signs you may not be eating enough, such as losing weight unexpectedly. Our guide on Healthy Living has more information about how to have a healthy diet and drink sensibly.

Keep active
As well as keeping you healthy exercise is a great way to improve your mood, as it increases the production of endorphins – brain chemicals that make you feel happy. Keeping active can also be a good way to clear your mind and relax. It’s never too late to be active and there are lots of simple ways to start moving more – even doing things like gardening or going for a walk can improve your mood.

Create structure to your day and set yourself goals
Most of us look forward to retirement and having time to ourselves, but when it comes it can be hard to adjust to the loss of structure in our day and the sense of purpose that working life gave us. Setting goals and making plans gives our lives meaning and purpose. Start small and make sure you’re realistic – for example, you may set yourself a goal to go for a 10 minute walk every day. Volunteering can also help to provide routine and structure.

Connect digitally
If you are comfortable with the internet and digital technology then try using it to stay in touch with family and friends. Video calling is a great way to chat with others. Keeping in touch with family, friends and other loved ones makes us feel more connected and helps with feelings of isolation and depression. Age UK has some easy to use guides that can help you make the leap into using digital technology to stay in touch. www.ageuk.org.uk

Another way we can all help is to take part in the Department of Health and Social Care public consultation on the mental health strategy. Age UK are encouraging older people to participate in the consultation to make sure their voices are heard. To have your say visit: www.gov.uk/government/consultations/

How we can all help
There are very simple ways we can all make a difference to those who are feeling depressed and isolated.  A friendly phone call or a visit for a cup of tea with an older person in your life could really brighten their day and help them feel connected again. Other important ways to support older people during this time include:

• Lending a hand around the home or collecting shopping.
• Giving out these useful numbers: For practical information and advice, Age UK Advice: 0800 169 65 65. For a cheerful chat, day or night, The Silver Line Helpline: 0800 4 70 80 90
• Fundraising - Age UK also needs your support to continue to run its vital services, providing comfort, reassurance and support to those older people who don’t have anyone to turn to.

ENDS

References:  

i) NHS Digital (2021), Psychological Therapies, Annual report on the use of IAPT services, 2020-21.
ii) Department of Health (2011), Talking therapies: A four-year plan of action

iii) Prevalence of Depressive Disorders, United Kingdom, 2019. Global Health Data Exchange, Accessed at https://ghdx.healthdata.org/gbd-results-tool on 3rd May 2021.
iv)  https://www.who.int/