Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-05T04:17:54.279Z Has data issue: false hasContentIssue false
  • English
  • Français

Barriers and facilitators to accessing psychological therapies for severe mental health difficulties in later life

Published online by Cambridge University Press:  24 October 2019

Katherine Berry ,
Jennifer Sheardown ,
Uma Pabbineedi ,
Gillian Haddock ,
Catherine Cross  and
Laura J.E. Brown
Katherine Berry*
Affiliation:
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
Jennifer Sheardown
Affiliation:
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
Uma Pabbineedi
Affiliation:
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
Gillian Haddock
Affiliation:
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
Catherine Cross
Affiliation:
Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
Laura J.E. Brown
Affiliation:
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The number of people growing older with severe mental illness (SMI) is rising, reflecting societal trends towards an ageing population. Evidence suggests that older people are less likely to seek help, be referred for and receive psychological therapy compared with younger people, but past research has focused on those with mild to moderate mental health needs.

Aims:

This research aims to identify the specific barriers faced by older people with SMI.

Method:

We interviewed 53 participants (22 service users with SMI aged over 50 years, 11 carers of people with SMI, and 20 health care professionals) about their views and experiences of accessing therapy for SMI in later life.

Results:

Thematic analysis revealed five themes: organizational and resource issues; myths about therapy and attitudinal barriers; stigma; encouraging access to therapy; and meeting age-specific needs.

Conclusions:

Barriers faced by older people with SMI are not only age-related, but also reflect specific issues associated with having a SMI over many years. Improving awareness of the benefits of psychological therapies is important not only for older people with SMI themselves, but also for their carers and staff who work with them.

Keywords

barriersfacilitatorslater lifepsychological therapyqualitative researchsevere mental illness
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 2 , March 2020 , pp. 216 - 228
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Age UK (2016). Report of Trustees and Annual Accounts 2016/17. London: Age UK.Google Scholar
Berry, K., & Barrowclough, C. (2009). The needs of older adults with schizophrenia Implications for psychological interventions. Clinical Psychology Review, 29, 68–76. doi: 10.1016/j.cpr.2008.09.010 CrossRefGoogle ScholarPubMed
Berry, K., & Haddock, G. (2008). The implementation of the NICE guidelines for schizophrenia: barriers to the implementation of psychological interventions and recommendations for the future. Psychology and Psychotherapy: Theory, Research and Practice, 81, 419–436.CrossRefGoogle ScholarPubMed
Berry, K., Purandare, N., Drake, R., Elmsley, R., Jones, L., & Barrowclough, C. (2013). A mixed-methods evaluation of a pilot psychosocial intervention group for older people with schizophrenia. Behavioural and Cognitive Psychotherapy, 42, 199–210. doi: 10.1017/s1352465812001075 CrossRefGoogle Scholar
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. doi: 10.1191/1478088706qp063oa CrossRefGoogle Scholar
Brown, L., Bowden, S., Bryant, C., Brown, V., Bei, B., Gilson, K. M., Komiti, A., & Judd, F. (2015). Validation and utility of the Attitudes to Ageing Questionnaire: links to menopause and well-being trajectories. Maturitas, 82, 190–196.CrossRefGoogle ScholarPubMed
Cohen, C., Meesters, P., & Zhao, J. (2015). New perspectives on schizophrenia in later life: implications for treatment, policy, and research. The Lancet Psychiatry, 2, 340–350. doi: 10.1016/s2215-0366(15)00003-6 CrossRefGoogle Scholar
Grey, N. (2009). Cognitive therapy for traumatic stress reactions: an introduction. In Grey, N. (ed), A Casebook of Cognitive Therapy for Traumatic Stress Reactions (pp. 17–29). Routledge.CrossRefGoogle Scholar
Healthcare Commission (2009). Equality in Later Life: A National Study of Older People’s Mental Health Sevices. London, UK: Healthcare Commission.Google Scholar
Huybrechts, K. F., Gerhard, T., Crystalm, S., Olfson, M., Avorn, J., Levin, R., Lucas, J. A., & Schneeweiss, S. (2012). Differential risk of death in older residents in nursing homes prescribed specific antipsychotic drugs: population based cohort study. British Medical Journal, 344, 1–12.CrossRefGoogle ScholarPubMed
Ince, P., Haddock, G., & Tai, S. (2015). A systematic review of the implementation of recommended psychological interventions for schizophrenia: rates, barriers, and improvement strategies. Psychology and Psychotherapy: Theory, Research and Practice, 89, 324–350.CrossRefGoogle ScholarPubMed
Kessler, E., Agines, S., & Bowen, C. (2014). Attitudes towards seeking mental health services among older adults: personal and contextual correlates. Aging & Mental Health, 19, 182–191. doi: 10.1080/13607863.2014.920300 CrossRefGoogle ScholarPubMed
Kyle, S., & Shaw, D. (2014). Doctor–patient communication, patient knowledge and health literacy: how difficult can it all be? The Bulletin of the Royal College of Surgeons of England, 96, e9–13.CrossRefGoogle Scholar
Laidlaw, K., & Knight, B. (2008). Handbook of Emotional Disorders in Later Life. Oxford, UK: Oxford University Press.CrossRefGoogle Scholar
Laidlaw, K., Thompson, L. W., Siskin-Dick, L., & Gallagher-Thompson, D. (2003). Cognitive Behavioural Therapy with Older People. Chichester, UK: John Wiley & Sons, Ltd.CrossRefGoogle Scholar
Levy, B. R. (2009). Stereotype embodiment: a psychosocial approach to aging. Current Directions in Psychological Science, 18, 332–336.CrossRefGoogle ScholarPubMed
NICE (2014). Psychosis and schizophrenia in adults: prevention and management. London: National Institute for Clinical Excellence.Google Scholar
Office for National Statistics (2017). Overview of the UK population: July 2017. London, UK: Office for National Statistics.Google Scholar
Parcesepe, A., & Cabassa, L. (2012). Public stigma of mental illness in the United States: a systematic literature review. Administration and Policy in Mental Health and Mental Health Services Research, 40, 384–399. doi: 10.1007/s10488-012-0430-z CrossRefGoogle Scholar
Public Health England (2018). Technical supplement. Severe mental illness and physical health inequalities. London, UK: Public Health England.Google Scholar
Prina, M. A., Marioni, R. E., Hammond, G. C., Jones, P. B., Brayne, C., & Dening, T. (2014). Improving access to psychological therapies and older people: findings from the eastern region. Behaviour Research and Therapy, 56, 75–81. doi: 10.1016/j.brat.2014.03.008 CrossRefGoogle ScholarPubMed
Robb, C., Chen, H., & Haley, W. (2002). Ageism in mental health and health care: a critical review. Journal of Clinical Geropsychology, 8, 1–12.CrossRefGoogle Scholar
Saad, K., & Bangash, A. (2016). Ageless mental health services and the future of old age psychiatry in the UK. Journal of Geriatric Care and Research, 3, 21–23.Google Scholar
Schizophrenia Commission (2012). The Abandoned Illness: A Report from the Schizophrenia Commission. London, UK: Rethink Mental Illness.Google Scholar
Svensson, S. A., Hedenrud, T. M., & Wallerstedt, S. M. (2019). Attitudes and behaviour towards psychotropic drug prescribing in Swedish primary care: a questionnaire study. BMC Family Practice, 20, 4.CrossRefGoogle ScholarPubMed
Vogel, D., & Wester, S. (2003). To seek help or not to seek help: the risks of self-disclosure. Journal of Counseling Psychology, 50, 351–361. doi: 10.1037/0022-0167.50.3.351 CrossRefGoogle Scholar
Wuthrich, V. M., & Frei, J. (2015). Barriers to treatment for older adults seeking psychological therapy. International Psychogeriatrics, 27, 1227–1236.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.