Healthcare Commission examines older people’s mental health care

The Healthcare Commission has begun a series of visits to mental health trusts to examine the quality of older people’s services, including levels of ageism, integration with social care and safety. The visits, which began last week, will take in six trusts, as part of a study of the quality of older people’s mental health care, which has been multiply criticised in a string of reports over the past decade.

Integration “patchy”

Julie Meikle, senior manager of the commission’s mental health strategy team, said while services for working-age people were often well-integrated, this was “patchy” for older people’s services. But she said the study, due to report in the autumn, was part of a wider current focus on improving older people’s mental health care, including the government’s dementia strategy launched last summer.

The issue of the safety of services was highlighted last week as the commission and the Royal College of Psychiatrists published an audit of violence on mental health wards, some of whose findings were trailed in December.

Violence against nurses

This found that 64% of nurses on older people’s wards had been assaulted in 2006-7, compared to 46% on wards for working-age adults. For nurses on wards for older people with dementia and other “organic” disorders, caused by changes to the brain, the figure was 73%. Despite this, nurses on older people’s wards were less likely to receive training in managing incidents, with two-thirds having done so compared to 75% of nurses on working-age wards.

The audit also raised concerns that about one-third of wards for older people mixed people with organic disorders with those with functional mental health problems, such as major depression or schizophrenia. It said this could put frailer patients with dementia at risk from stronger patients with functional problems, while sharing a ward with someone with dementia could adversely affect the treatment of someone with a functional disorder.

Violence against patients

However, working-age patients faced higher levels of violence than older service users, with 18% being physically assaulted, compared to 6% of older patients, and 34% being made to feel unsafe, compared to 29% on older people’s wards. And 92% of older people said they were cared for in a dignified manner, compared to 83% of working-age service users.

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