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Therapies just as helpful in elderly

By Lilian Anekwe

Psychological therapies are just as effective in older as in younger patients according to evidence collected for NICE that leaves Department of Health policy open to accusations of ageism.

The evidence was collated as part of a consultation by NICE's Public Health Interventions Advisory Committee (PHIAC) for its forthcoming primary care guidance on promoting older people's mental health.

It leaves the Government's practice of expanding psychological therapies only for those of working age under criticism.

Pulse has previously reported criticism from GPs and Lord Layard, author of the 2006 Depression Report, of the Government's decision to restrict access to psychological therapies to younger adults.

The systematic review, compiled by researchers at the University of Wales, Bangor, found ‘strong evidence' for the effectiveness and cost-effectiveness of psychological interventions in the elderly.

The report said cognitive training, control-enhancing interventions, psycho-education, relaxation and supportive interventions have all been found to improve the subjective wellbeing of older people.

The findings apply to relatively healthy and independent patients in the community.

The report also reflected criticisms made by the Royal College of Psychiatrists, which accused the Government of trying to offer psychological therapies ‘on the cheap' by using less-qualified and lower-grade staff.

'Professional qualification of the therapist influences effect size. For psychological interventions the greatest improvement in subjective wellbeing was found when the therapist had both a postgraduate degree and professional experience or training working with older adults,' the report said.

Report author Professor Bob Woods, professor of clinical psychology of older people at Bangor University, said: ‘There's a lot of evidence that shows older people can benefit from psychological interventions.

‘The NSF clearly says we have got to write-off age discrimination.'

On the accusations of providing psychological therapies on the cheap, Professor Woods said it was important that any psychological therapy was provided ‘by people who are adequately trained and supervised, especially in complicated cases'.

A substantial part of the evidence base for the NICE consultation was drawn from an Age Concern inquiry into mental health and wellbeing in older people, published last month.

Policy manager Philip Hurst, who worked on the report, said older people very rarely received access to psychological therapies because of ‘strong age discrimination, both implicit and explicit'.

Mental wellbeing in older peopleMental wellbeing in older people Mental wellbeing in older people

- Older people have some of the highest suicide rates in the UK
- Depression is the leading risk factor for suicide
- One in four older people living in the community has symptoms of depression that are severe enough to warrant intervention
- Only a third of older people with depression ever discuss it with their GP, and only half of them are diagnosed and treated

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