Abstract
BackgroundOne-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers.MethodsSemi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison.ResultsNineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self-worth and the value of group activities, and tensions in existing service provision, including barriers and gaps.ConclusionsThe experience of loss was seen as central to feelings of anxiety and depression among community-dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector workers to deliver the intervention.
Highlights
One-in-five people in the UK experience anxiety and/or depression in later life
The qualitative study forms part of a feasibility study, the NOn-Traditional providers to support the management of Elderly People with Anxiety and Depression (NOTEPAD) [33]
Interviews were completed with 19 older people (18 female; mean age 74 years at point of participation) and 9 third sector workers (8 female; 4 in paid employment, 4 volunteers)
Summary
Anxiety and depression remain poorly detected in older people, in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. One-in-five older people (65+ years) in the UK experience anxiety and/or depression with prevalence increasing with age [1,2,3,4,5]. Anxiety and depression in older people remain poorly detected and managed [10], for people with chronic physical ill health [11]. Task shifting mental health care to communitybased programmes has been shown to be effective in low and middle income countries [18, 19]; evidence from the UK is limited
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