NHS ageism means elderly people with depression far less likely to be referred for therapy

NHS ageism means GPs are failing to properly treat depression in the elderly, research suggests. Experts said older patients were far less likely to be referred for psychological therapies, and more likely to just be given pills. 

The study by University College London and the University of Bristol found that almost four in ten people over the age of 75 are suffering some signs of depression.

But the research found older patients were far less likely than younger ones to be referred for therapy, with GPs often assuming depression was a natural consequence of old age.

The review, published in the British Journal of General Practice, examined 27 studies examining late-life depression.

It found that around one in 10 of those aged over 75 have major depressive disorder, with more than 37 per cent classed as having subthreshold depressive symptoms.

As few as 3.5 per cent of cases were referred for therapy - with even fewer cases among the oldest patients, the study found.

Overall, those aged 85 and over were five times  less likely to be referred for psychological therapies, as those in their late 50s, the review found.

And the older patients were one third more likely to be prescribed an antidepressant.

Researchers said “ageist stereotypes” among GPs, therapists and nurses meant they too often assumed older people would be “unwilling to change” or uninterested in talking therapies.

“Late-life depression was felt to lack suitable therapeutic solutions as it was considered to mainly arise from ‘justifiable’ causes, many of which related to ageing,” the authors said.

“GPs described depression as part of a spectrum including loneliness, lack of social network, reduction in function, and very much saw depression as ‘understandable’ and ‘justifiable,’” they found.

Professor Helen Stokes-Lampard, Chairman of the Royal College of GPs, said: “Whilst antidepressants can be effective drugs, we know that in general patients don’t want to be on long-term medication – and GPs don’t want that, either.

"We will always try to explore alternative therapies, such as CBT and talking therapies, but access to these therapies in the community is patchy across the country – and there is also a lack of variety, to allow us to match these services to the specific needs of our patients.

“We do know that for many older patients, the underlying reasons for them visiting their GP might not be medical – they might be feeling lonely or be socially isolated.

"In these cases, it’s important that we have access to ‘social prescribing’ schemes to link these patients with an appropriate class or group in the community, that can have a positive effect on their health and wellbeing, and we welcome the focus on this in the NHS long term plan."