Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Age Discrimination and Age Discrimination and mental health services: mental health services:

Making Equality a RealityMaking Equality a Reality

Dr Dave AndersonDr Dave AndersonChair, Faculty of Old Age PsychiatryChair, Faculty of Old Age Psychiatry

Royal College of PsychiatristsRoyal College of Psychiatrists

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Policy Change

Age 65* working age adults* older people

Need not age

Age Proxy* nature of disorders* co-morbidity* lifecycle* delivery & treatment

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Challenge

• Ageing population

• Discrimination barrier

• Post code commissioning

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Discrimination

Under 65

• Rehabilitation

• Psychotherapy

• Hospital liaison

• Addictions

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Discrimination

NSF-MH (1999)

* £2B* Assertive Outreach* Early Psychosis* Crisis home treatment

PSSRU (2007) £2B

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Commissioning

• Dementia

• Functional* Depression* Psychosis

• One size fits all

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Crisis Home Treatment

• 8.8%

• 50% cost per day

• ↓ hospital admission 16-31%

• ↓ care home discharge 7%

• ↓ hospital stay 36 days

• carer satisfaction

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Hospital Liaison

• 27%

• ↓ hospital stay* dementia 16 days* 2 days (24,000 p.a.)

• ↓ re-admission

• ↓ health care utilisation

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Hospital Liaison

• ↓ bed days* dementia 1056 p.a.

• ↑ independent living

• Cost* £1.5 M/2 years* £6.5 M p.a. (NAO)

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Care Home Liaison

• ↓ drug prescribing (£14 M)

• ↓ GP time

• ↓ hospital admission 75%

• trained 600 staff in 2 years

• ↑ QOL

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Next Steps……..

National Drivers

• Dementia Strategy

• New Horizons

• Equality Bill

• IAPT

● Ageing Strategy

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Next Steps……..

• Need not age

• Specialist OPMHS* re-configured* equity

• Better access

• Choice

Source: www.southwest.nhs.uk/age-equality.html Source: www.southwest.nhs.uk/age-equality.html

Equality

NOTNOT treating all people the same treating all people the same

BUTBUT

Recognising their differencesRecognising their differences