Memorandum by Department of Health's Older
People's Mental Health Programme Delivery Board
GOVERNMENT RESPONSE TO THE EUROPEAN COMMISSION
GREEN PAPER IMPROVING THE MENTAL HEALTH OF THE POPULATION: TOWARDS
A STRATEGY ON MENTAL HEALTH FOR THE EUROPEAN UNION
GENERAL
The Green Paper (although it does touch on OPMH
issues) seems to focus predominantly on services for working age
adults (WAA).
Sections 1 through 5 focus predominantly on
issues relating to WAA.
The focus is also mainly on functional and not
organic illness. It would be useful for example to refer in the
"Introduction" and, particularly, in Section 3 under
the heading "Mental Health, A Growing Challenge for the EU"
to the pressures created on public services by the growing population
of older people.
Pressures created by an ageing population are
well-documented, most recently in the Wanless Social Care Review:
Securing Good Care for Older People. In the next 10 years, the
number of people aged over 65 will increase by 15 per cent, and
the number of people aged over 85 will increase by 27 per cent.
We are therefore likely to see a significant increase in the incidence
of age-related mental health problems.
Current figures show:
— Depression is present in about 12
to 15 per cent of people aged over 65.
— Dementia affects one person in 20
aged over 65 and one person in five over the age of 85
4.1 The European Community, its mandate and
activities in the field of mental health
The Green Paper states that the DAPHNE II programme
combats violence against children, young people and women. There
is no reference to how the Community handles issues relating to
the protection of other vulnerable adults, and particularly what
measures it has taken to confront the issue of elder abuse.
It might be worth referring to the No Secrets
guidance launched in the UK in 2000 to improve the levels of support
and protection for adults considered vulnerable to abuse; and
the recently-released, DH-commissioned study into Adult Protection
Recording Systems in England, carried out by Action on Elder Abuse.
The issue of elder abuse should also be included
in section 6.2 "Promoting the social inclusion of mentally
ill or disabled people and protecting their fundamental rights
and dignity".
4.2 Mental Health in Member States
The figures given for suicide rates are not
disaggregated according to age but again it is worth mentioning
the significant proportion of suicides in the at-risk group of
men aged 75+.
6.1.1 Promoting mental health in older people
Everybody's Business (DH/CSIP 2005), DH's new
service development guide which outlines the elements of a comprehensive
older people's mental health (OPMH) service, identifies promoting
good mental health for older people as a cross-cutting issue.
It is worth including access to advocacy and
specialist advice; lifelong learning; volunteering; transport;
finance and benefits; housing and safety and environment alongside
health, social care and social activities in the list of essential
pre-requisites for ensuing good mental health for this client
group.
Useful research has been done on key drivers
of quality of life in older people, for example Adding quality
to quantity. Older people's views on quality of life and its enhancement
(Bowling and Keneally).
The Commission may wish to be aware of the work
of the UK Inquiry into Mental Health and Well-Being in Later Life
which is being conducted by Age Concern and the Mental Health
Foundation.
The Inquiry has undertaken work to raise awareness
and create better understanding of mental health promotion in
later life. Work to date has included:
— A review of literature and policy.
— Gathering evidence from older people.
This was done via a written questionnaire which generated nearly
900 responses; focus groups with Black and minority ethnic older
people and older lesbians, gay men and bisexuals; and various
consultation events.
— Gathering evidence from organisations
and professionals. This was done via a written questionnaire which
generated nearly 200 responses; roundtable discussion groups;
and various presentations and workshops.
Reports of this work are available on the Inquiry
website at www.mhilli.org.
It is also worth noting that the National Institute
for Clinical Excellence (NICE) are considering promoting good
mental health as one of a range of possible candidate topics for
public health guidance.
ANNEXES
The Green Paper's supporting annexes also focus
on WAA or on children's transition into adult services.
As noted before, the information on suicide
is not disaggregated according to age but it is worth noting that
the second highest at risk group for suicide is men aged 75+.
The table detailing the financial costs of social
exclusion has a clear focus on WWA. The economic case for preventative
services and activities in relation to older people is well set
out in Making Life Better for Older People (Social Exclusion Unit,
ODPM).
For example, for an annual cost of £1.5
million, Manchester City Council forecast the following potential
benefits:
— Supporting older people to live at
home: Estimated benefit of £1.4 million per year.
— Preventing the need for higher intensity
care: Forecast benefit of £1.4 million per year.
— Reducing avoidable, emergency admissions
and bed days: Forecast benefit of £11k per year.
— The net present value of benefits
minus costs: £25 million over 10 years (base case scenario).
Partnerships for Older People Projects (POPPs)
grants aim to encourage councils in England to devise innovative
approaches with their NHS, local government, voluntary and community
sector partners to establishing sustainable arrangements for supporting
older people in active and healthy living.
CONCLUSION
DH OPMH Programme Board members welcome the
suggestion of an EU-strategy on mental health, but feels that
further work is necessary to ensure that this strategy is properly
age-inclusive.
| 
