Wise Connections – Older Adults Primary Care Mental Health

What was the issue you were addressing or working on?

Older adults are under-represented in Primary Care Mental Health. Potential barriers include the perception that common mental health problems are an inevitable part of growing old, social isolation preventing older people accessing psychological therapy services, older people’s views, behaviours and attitudes may get in the way of them receiving psychological therapy and health professionals may inadvertently prevent older people from accessing psychological therapy.

Whilst many older people enjoy an active and fulfilling life, many may develop physical and psychological problems. In long term physical conditions, psychological factors have an important role in helping or hindering people’s responses to the treatment of such conditions.

Failure to address psychological elements hinders rehabilitation, leads to unnecessarily poorer outcomes and overloads hospitals and health care systems.

What you did?

The aim of Wise Connections is the prevention and psychological treatment of common mental health problems in the older adult population, including their carers.

The following case example highlights a typical scenario:

  • Female patient referred by GP for low mood following bereavement of spouse. Issues present were low self-esteem and relationship with adult children and avoidant behaviours.
  • Patient and therapist jointly agreed on 1:1 guided self-help CBT with areas chosen by patient to focus on were improving self-esteem, assertiveness, SMART goals and activity scheduling.
  • Reduction in CORE10 scores from clinical category of ‘moderate – severe’, to non-clinical category of ‘healthy’ at end of treatment. Improvement in feeling confident in self-managing in future using learnt self-help techniques.

What were the outcomes - benefits or otherwise?

The case example above highlights the variety of benefits:

  • Improved take-up amongst older people who were previously under-represented in Primary Care Mental Health. Over 600 interventions have been delivered to date.
  • Improving clinical CORE10 scores from ‘severe’ to ‘healthy’ including being confident in self-managing in the future, as well as longer-term benefits in being able to continue their social lives.

In terms of the service itself, the following benefits have been realised:

  • Raising awareness – Wise Connections seeks out opportunities on an on-going basis to engage with services and community groups. As a result referral rates to Wise Connections are steadily increasing.
  • Training – In partnership with the WISH Programme and the CHCP Training Department, the delivery of training in the use of low key, evidence-based psychosocial interventions (Living Life to the Full) including participants from Kirkton Service, Carers’ Centre, sheltered housing and the Reablement Service. The Carers Centre has purchased a licence, is delivering the Living Life to the Full course and has used the materials with individuals.
  • Volunteers – in partnership with the WISH Programme and Voluntary Action, the recruitment and training of peer volunteers to deliver evidence-based, psychosocial interventions in a class setting (Living Life to the Full course) in the local community.
  • Psychological therapies – low and high intensity interventions are delivered to individuals within clinic and community settings with services being delivered in people’s own homes as required. CORE 10 is used to monitor clinical outcomes; with satisfaction rated using CSQ-8 and anecdotal evidence. Case examples have consistently demonstrated improvements in personal outcomes as well as clinical scores.

Contacts - to find out more

Amanda White, amanda.white@ggc.scot.nhs.uk 07500037734

Karen Meechan, CBT Therapist (Wise Connections – Older Adults Mental Health)

Karen.Meechan2@ggc.scot.nhs.uk 0141 300 1228