Working with older people with mental health and/or addiction needs

Ageing and its implications are increasingly on the minds of many New Zealanders. Average life expectancy in the population is increasing over time (currently around 82 years on average). Today, many people can reasonably expect to live 15 to 20 years in retirement, and some much longer. We are encouraged to adopt lifestyles that support healthy ageing and to save so we can resource our desired retirement lifestyle. But not everyone will consistently experience health, happiness and fulfillment in later life. 

As described at the recent Health and Care Services for New Zealand’s Ageing Population conference (April 2019), population ageing will be a key driver for increasing pressure on health systems and workforce. Increasing diversity in the older population will require a wider range of health services based on cultural understandings of ageing, particularly for Māori people, and to meet the needs of minority groups such as people with limited English language skills. Feedback received from the sector working with older people who have mental health and addiction problems is that services are experiencing substantial demand pressures, and this is expected to increase over time.  

Older people can experience considerable distress due to problems with mental health or substance use; and there are overlaps between physical and mental health, and neurodegenerative conditions like dementia. There are widespread myths and misperceptions in New Zealand communities that older people do not have mental health and addiction problems or that these are just due to ageing and there is nothing that can be done to relieve these. In reality, primary prevention and early intervention activities, and secondary care treatment and support can substantially relieve suffering and distress to improve older people’s quality of life. 

The size of the older people’s population is expected to grow by 40 per cent in the next 10 years.

Te Pou has begun a 3-year project looking at workforce development for people working with older people (aged 65 years and older) with mental health or substance use problems. The first phase of the project is currently nearing completion. In this phase, we reviewed a wide range of literature and consulted with mental health and addiction sector experts to better understand older New Zealanders’ experiences of mental health and addiction, prevalence rates, service access and workforce development needs. 

Key findings include:

• the size of the older people’s population is expected to grow by 40 per cent in the next 10 years
• as many as 1 to 2 in every 6 older New Zealand may experience mental health or substance use problems, with people who are unwell, living in aged care or other residential facilities having the highest rates
• there is likely to be substantial unmet mental health and addiction need among older New Zealanders
• the most common mental health problems are depression and anxiety, and alcohol is the most commonly used substance. The prevalence of other substance use among older people is increasing with time. 

This phase of the project has concluded with identification of 10 workforce development priorities to be reported to the Ministry of Health in late May 2019. We will then publish the report in the resource centre, and its content will inform our next phase to identify and design specific workforce development activities. Please do make contact if you are interested in hearing more about the project and next steps.