1. Everybody’s Business
Integrated mental health services for older adults
A service development guide

2. Everybody’s Business: Guidance and Key Messages
Lesley Carter and Claire Goodchild
London
Care Services Improvement Partnership

3. The sections: Introduction Foundations Primary and community care
Intermediate care 
Care for people in the general hospital
Other specialist mental health services
Special groups
Annexes: Service assessment, policy drivers

4. Everybody’s Business
Integrated mental health
services for older adults
Key messages for Commissioners

5. Older people’s mental health is everyone’s business
• Mental health problems are widespread:
40% of people visiting their GP
50% of general hospital inpatients
60% of people who live in care homes
Depression is more common and worsens outcome
in people with long term conditions
• Population increase in the next 10 years:
15% increase in the over 65s
27% increase in the over 85s
• Caring for people with Alzheimer’s disease costs
more than the combined cost of stroke, cancer and
heart disease

6. 2) Improving services for older people
with mental health problems will help
meet national targets and standards
• Commissioners can:
Improve outcomes for service users and carers Generate savings by improved efficiency
• Improving mental wellbeing in older people will
support the delivery of a number of national
targets and core standards:
Reducing emergency inpatient bed days
Enabling people to live independently at home
Reducing death from suicide

7. 3) Access to mental health services should be based on need not age
• DH is committed to age equality in mental
health services
• Services need to be user led rather than service led
• The specialist service requirements of older people with mental health problems still need to be recognised and addressed

8. 4) Older people need holistic care in mainstream services
• DH is committed to developing health and care services that address mental and physical health needs
• Services should start with the needs of the individual, offer choice and support wellbeing and independence
• Whatever the setting, older people with mental
health problems should not be discriminated
against and should have their mental health needs
met.

9. 5) Workforce development is central to driving service improvement
• Older people with mental health problems and their
carers often have complex needs. There are few
areas where the quality of the workforce matters
more
A properly skilled workforce throughout health and
social care is fundamental to delivering better
mental health for older people
• It is vital to include mainstream staff in workforce
development, education and training as well as staff
specialising in mental health care

10. 6) Whole system commissioning and leadership are vital to deliver a
comprehensive service
• A co-ordinated approach is needed across all
health and social care – with links to housing,
the voluntary sector etc
• Strong leadership across health, social services,
local authorities and the voluntary sector is
essential to:
Communicate the vision of age inclusive and holistic services
Ensure the delivery of lasting results

11. So what is going to make it happen?

12. Supports: DH OPMH Programme Board
Care Services Improvement Partnership:
website:
Service and financial mapping
The Commission for Social Care Inspection and the Healthcare Commission
Our health, our care, our say: a new direction for
community services:
“Commissioners and providers of services will
need to become familiar with this guide”

13. Quality and Outcomes Framework
(Changes from April 2006)
• Making working age adult mental health indicators age-inclusive
• Screening for depression in people with
diabetes and heart disease
• New indicators involving a dementia
register in primary care
• Extending the palliative care disease
register to people with frailty and dementia

14. What happens next?

15. Other key events to watch out for: -
‘Next Steps’ – NSF update
SCIE/NICE Dementia Guideline
Mental Capacity Act implementation
Mental Health Bill

16. London CSIP implementation programme
OPMH programme
OPMH network
Frontline providers
Commissioners/strategic planning
Service improvement directly with mental health trusts
Influencing wider CSIP mental health programmes
Working alongside King’s Fund OPMH Development Programme
Working with the whole system
Supporting OPMH needs across health and social care

17. Supporting Implementation
Web based resources
OPMH website
Change Agent Team website