Read Standard 9: Mental health and mental wellbeing

Rationale

Mental health is a state of mental wellbeing that enables people to cope with the stresses of life, realise their abilities, learn well and work well. It is about life satisfaction, optimism, self esteem, feeling in control, having a purpose and a sense of belonging and support.⁹³ Social isolation and loneliness is associated with physical health conditions such as cardiovascular disease and stroke.⁹⁴ Preventative activity to improve and maintain brain health and mental wellbeing should be considered in line with Standard 8.

Older people with frailty may experience depression, loneliness and low levels of satisfaction and wellbeing.⁹⁵ As people age, they may need support to adapt to changes in their life and health. Declining health and loss of abilities may affect a person’s mental wellbeing and their engagement with the world and with others.¹³ Pain, illness, falls, lack of energy and loss of memory may challenge a person’s sense of identity, meaning and purpose. Anxiety in older people is more likely to be undiagnosed or normalised. It is linked to adverse health outcomes.⁹⁶ Validated tools should be used to screen for mental health conditions in older people with frailty.

Dementia impacts mental health by affecting cognitive function and emotional wellbeing. People living with dementia may experience cognitive decline, mood changes and behavioural issues including aggression and hallucinations.⁹⁷ This can lead to social isolation and increasing feelings of loneliness and depression. People who have been diagnosed with dementia should be offered specialist support for a minimum of 12 months.⁹⁸

Some people grow old with enduring mental health conditions. A small number of people develop these conditions later in life. People with long-term mental health conditions should have access to psychiatry through specialist referral pathways.

Criteria

9.1

Organisations have processes to identify and respond to stress and distress, confusion and anxiety.

9.2

Staff use validated tools to assess the mental health needs of older people with frailty.

9.3

People’s mental health needs are documented in their care plan and shared with the person, their unpaid carer or care partner and relevant staff.

9.4

People receive postdiagnostic support for a minimum of 12 months following a diagnosis of dementia.

9.5

Frailty pathways include acute mental health support during crisis to ensure older people with frailty are looked after in the right place.⁹⁹

9.6

People with long-term or enduring mental health conditions have equitable access to physical health interventions to manage frailty.

What does this standard mean for...

What does the standard mean for people?

Your mood, mental health and psychological state will be recognised, assessed and cared for.
Staff will take account of any mental health or psychological issues you have when they are caring for you.
You will be referred for specialised mental health care if you need it.

What does the standard mean for staff?

Staff, in line with roles, responsibilities and workplace setting:

routinely assess the mental health of older people living with frailty
refer people to mental health services as required
work with specialist mental health teams to support older people with frailty.

What does the standard mean for the organisation?

Organisations:

have systems and processes in place to identify and respond to the mental health needs of older people with frailty
have referral pathways to specialist input where required.

Examples of what meeting this standard might look like

Waiting time for specialist psychiatry input.
Referral pathways to mental health treatment.
Implementation of mental health standards.
Consistent screening of mental wellbeing and mental health conditions.
Evidence of meaningful activities and engagement strategies to reduce stress and distress in people living with delirium or dementia.