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Independents' Day

GPs 'ignore' depression in elderly, claims report.

By Ingrid Torjesen

GPs are ignoring the signs of depression in patients aged over 65, a new report claims today.

The UK Inquiry into Mental Health and Wellbeing in Later Life, funded by Age Concern, found that up to 2.6 million older people have depression or serious symptoms of it, or one in four people aged over 65 and two in five over 85.

But the inquiry concluded that older people with mental health problems are often ignored and receive little support.

Two-thirds of older people with depression never discuss depression with their GP and of the third that do only half are diagnosed and treated.

The inquiry makes 35 recommendations on ways to improve mental health services for older people, including creating incentives within the quality and outcomes framework for GPs to identify and treat depression and anxiety to tackle the problem of under-diagnosis and under-treatment. Age discrimination and underfunding in mental health also needs to be tackled, it says, and housing, health and social care services improved.

Dr June Crown, chairman of the inquiry, said: ‘Mental health problems in later life are not an inevitable part of ageing. They are often preventable and treatable, and action to improve the lives of older people who experience mental health difficulties is long overdue.

‘Current services for older people with mental health problems are inadequate in range, in quantity and in quality.'

The report says older people also have high rates of suicide. Women over 75 are the most likely to take their own lives and men aged over 75 have the second highest suicide rates of men.

Dr Richard Byng, a GP with a special interest in mental health in Plymouth, Cornwall, conceded that older people may face ‘some form of age discrimination', particularly in access to psychological therapies in some areas. But in most cases he did not think the discrimination was ‘overt or deliberate'.

Diagnosing depression was particular difficult in older patients, he said.

‘It is not as simple as do you detect yes or no, you require some level of distress to be elicited and then you need to have a conversation with the patient and for them to acknowledge that there is some kind of distress. Those stages are more difficult with older people who may not want to admit to distress.'

The inquiry's report is the second in a week to highlight alleged gaps in GPs care for people with mental health probems

Last week independent mental health provider, The Priory Group, claimed a significant number of patients were hiding serious mental illness from their employers by requesting sick notes from GPs for ‘stress' rather than more receiving accurate reports about psychiatric problems.

In its report, A Crying Shame, Dr Natasha Bijlani, consultant psychiatrist at The Priory Group, says: ‘It is quite common for patients with mental illness to ask for letters to their employers to be sent under the auspices of their GP, rather than their consultant psychiatrist, enabling them to maintain the illusion of positive mental health. Unfortunately, there is only so long that a GP can sign a patient off work for being 'stressed', when the problem is actually acute depression or an anxiety disorder.'

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