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Mental Health Considerations in Older Adults: a literature review

Posted on 8th August 2019 by Samina Miah

Evidence Reviews
Older woman in black and white holding mobile phone
During the final year of their Paramedic Science (BSc Hons) course at Oxford Brookes University, students carry out a literature review and critical appraisal of a topic relevant to their future practice.  This blog presents the abstract of a literature review on ‘Mental Health Considerations in Older Adults‘.   Other Paramedic topic blogs can be found here.

Background

There is a large amount of evidence to suggest that there are mental health issues within the over 65 population. Despite this, mental health services remain under-utilised by older adults and they have a higher likelihood of undetected and untreated mental illness. Many of the elderly do not receive an assessment for their mental health. Mental health is becoming an increasing part of the workload for a paramedic and there is still a stigma attached to those who engage in providing care for the mentally unwell. Many have a “take them all to hospital” approach to these patients, which is not suitable if we look at the changing role of the paramedic whereby paramedics are becoming further involved in psychosocial care, warranting the investigation into what paramedics can consider and do to better geriatric mental health care.

Method

The databases PubMed and PSYCInfo were utilised. Papers were searched for, using specific search terms and then filtered using inclusion and exclusion criteria. Overall, six studies were selected and appraised, with guidance from the CASP tools.

Results

Four themes were identified across the papers. Lack of education, physical illness, self-management/self-care abilities and non-pharmacological treatments all were found to play a significant role in older adult mental health care. Education, illness and poor self-management all intertwined as risk factors for mental health illness in older adults and exist as barriers, for older adults, to mental health care utilisation. Two randomised controlled trials investigated non-pharmacological treatments for late-life mental health and found them to be promising alternatives to pharmacological interventions.

Conclusion

There is a knowledge-gap amongst paramedics. Paramedics need to undergo educational programmes to increase their awareness of mental health in the geriatric population and the way in which they present. They must also promote better mental health amongst older adults.

Papers reviewed:

1. Fässberg, MM, Cheung, G, Canetto, SS, Erlangsen, A, Lapierre, S, Lindner, R, Draper, B, Gallo, JJ, Wong, C, Wu, J, Duberstein, P and Waern, M. (2016). ‘A systematic review of physical illness, functional disability, and suicidal behaviour among older adults,’ Ageing and Mental Health, 20(2), pp. 166-194.
2. Geboers, B, Winter, A, Spoorenberg, S, Wynia, K and Reijnevald, SA. (2016). ‘The association between health literacy and self-management abilities in adults aged 75 and older, and its moderators,’ Quality of Life Research, 25(11), pp. 2869-2877.
3. Garrido, MM, Kane, RL, Kaas, M and Kane, RA. (2011). ‘Utilization of Mental Health Care by Community-Dwelling Older Adults,’ Journal of the American Geriatrics Society, 59(1), pp. 50-56.
4. Stobbe, J, Mulder, NCL, Roosenschoon, B, Depla, M and Kroon, H. (2010). ‘Assertive community treatments for elderly people with severe mental illness,’ BMC Pyschiatry, 10, pp. 84.
5. Hegeman, JM, Waal, MWMD, Comijs, HC, Kok, RM and Van Der Mast, RC. (2014). ‘Depression in later life: A more somatic presentation?’ Journal of Affective Disorders, 170(2015), pp. 196-202.
6. Janssen, N, Huibers, M, Lucassen, P, Voshaar, RO, Marwijk, HV, Bosmans, J, Pijnappels, M, Spijker, J and Hendriks, G. (2017). ‘Behaviours activation by mental health nurses for late-life depression in primary care: a randomized controlled trial,’ BMC Psychiatry, 17, pp. 230.

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Samina Miah

Samina has just completed her final year as a Paramedic Science student at Oxford Brookes University. View more posts from Samina

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One Comment on Mental Health Considerations in Older Adults: a literature review

  • Atofy

    How do I do a critical appraisal of a topic relevant to future practice?

    5th November 2019 at 5:49 pm
    Reply to Atofy

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