Older adults are far more likely to be prescribed antidepressants than to be referred for psychological therapies to treat depression, according to new research.
The study carried out by the University College London and Bristol University found that older people generally report a preference for talking therapies over taking antidepressants, especially for low-level symptoms, and a willingness to talk to mental health providers about their emotional health.
However, in some areas of the UK, as few as 3.5% of over-65s are recommended to see a therapist and this inequality increases with greater age; those aged 85 and over are five times less likely to be referred for psychological therapies as those aged 55–59 years, and one-third more likely to be prescribed an antidepressant, the study found.
Almost one in 10 over-75s are thought to suffer from depression, while 37.4% exhibit some symptoms. However, the vast majority, 87%, are treated with medication, even though it often does not help, according to the findings.
Researchers looked at 27 studies that predominantly focused on the views of GPs and primary and community care nurses.
They found that limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty.
Dr Rachael Frost from UCL Institute of Epidemiology & Health Care, lead author of the paper, said: “There needs to be greater access to talking therapies for older people suffering with depression.”
In addition, she and her fellow researchers said mental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life.
“This may facilitate future identification and management of depression,” they said.
Responding to the study, Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said GPs “only ever recommend antidepressants after a full and frank discussion with the patient and if we genuinely believe they will help them”.
“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,” she added.