A new study has found that 10% of adults aged over 75 have major depressive disorder, and over one third sub-threshold depressive symptoms.
However, drug treatment for this vulnerable group is the rule, with comparatively few older patients having access to psychological therapies – non-drug therapies such as talk therapies, mindfulness, community activities, internet-based interventions, and bibliotherapy.
The study, published in the British Journal of General Practice (BJGP) stated that those over the age of 85 are five times less likely to be referred for psychological therapies than people in their 50s, and concluded that “mental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life.”
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, commented on the study, saying: “We do know that for many older patients, the underlying reasons for them visiting their GP might not be medical – they might be feeling lonely or be socially isolated. In these cases, it’s important that we have access to ‘social prescribing’ schemes to link these patients with an appropriate class or group in the community, that can have a positive effect on their health and wellbeing, and we welcome the focus on this in the NHS long term plan."
The study also found that that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited and because of the complexity of needs in later life, physical health is often prioritised over mental health, particularly in the frailest patients.
Professor Stokes-Lampard continued: “GPs are highly-trained to prescribe and will only ever recommend antidepressants after a full and frank discussion with the patient sitting in front of us, based on their individual circumstances, and if we genuinely believe they will help them.
“Whilst antidepressants can be effective drugs, we know that in general patients don’t want to be on long-term medication – and GPs don’t want that, either. We will always try to explore alternative therapies, such as CBT and talking therapies, but access to these therapies in the community is patchy across the country – and there is also a lack of variety, to allow us to match these services to the specific needs of our patients.”