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Clinical knowledge and experience, and demographic changes, indicated the need to ensure provision of adequate ‘psychogeriatric’ services to provide treatment for mentally ill older people (generally over 65 years). Various factors influenced the provision of these services, including politics, economics and stereotypical negative attitudes towards older people. Clinicians successfully led service developments, often unsupported by central government and local health authorities, despite benefits being noted in the localities where services were established. In 1989, services were available to most of the population of England and the Department of Health officially recognised psychogeriatrics as a medical specialty. [ABSTRACT FROM AUTHOR]

Demographic trends, and older people over 65 years disproportionately occupying beds in psychiatric hospitals, pointed to their increasing clinical needs. Clinical work with older people often required different skills from work with younger people. 'General psychiatrists', nominally working with adults of all ages, usually had little interest in working with older people. By 1977, it was clear to clinical leaders in the field of psychogeriatrics that official recognition of their specialty by the government was essential to ensure service development. Official recognition would provide the means to collect data to identify gaps in services, to obtain information on the implementation of government guidance and to advocate for resources, including ensuring high quality training posts for doctors wanting to specialise in the field. Doctors have traditionally taken the lead in creating new medical specialties, and psychogeriatrics was no exception. However, support fluctuated towards the specialty from the leadership of the Royal College of Psychiatrists. Health service leaders who did not undertake work with older people, were incredulous that others wished to do so. Negotiations between the Royal College of Psychiatrists and the Department of Health and Social Security about recognising psychogeriatrics were convoluted and prolonged. Recognition was achieved in 1989, following intervention by the Royal College of Physicians of London. [ABSTRACT FROM AUTHOR]

The article presents a study regarding the provision of mental health services for older people in England. The increasing number of elderly who are consequently experiencing a higher-prevalence of old-age related chronic degenerative mental illness and disorders led to the plans to close mental hospitals in the 1970s. The said plans have given rise for the necessary development of community mental health services for older people requiring mental health care.

The article presents a study that examines the 1959 and 1983 Mental Health Acts in England and Wales. One issue that is being tackled in this study is the consent to treatment which was not mentioned in the 1959 legislation that assumes that a detained patient could be treated against his will. Furthermore, this study evaluates the issues in England and Wales who advocated and enabled this important change to come about, using examples from the clinical practice of electroconvulsive therapy.

The article traces the history of psychiatry for old people in Great Britain. In the 1940s, some of the renowned psychiatrists such as David K. Henderson and Aubrey Lewis were taking an active interest in the well being of older people. Spurred on by the fears of a rising population of older people, overcrowding in mental hospitals, social changes and an awareness of the lack of knowledge of older people's mental illness, they and others began to explore further the mental health needs of older people. The establishment of the new specialty of geriatric medicine and inception of the National Health Service gave further impetus to service development.

Background The psychiatry of old age in Britain can be traced back to the 1940s. Provision of services for mentally ill older people, however, did not become widespread until the 1970s. Method Survey of archive sources, published work, and oral history interviews relating to the development of services for mentally ill older people in Britain between 1950 and 1970. Results and conclusions Despite considerable progress in research leading to a firm academic foundation for the specialty of old age psychiatry, there was relatively little progress made in the coordinated development of services from 1950 to 1970. A new generation of old age psychiatrists began to take service delivery issues forward at the very end of the 1960s and into the 1970s. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Provides information on a study investigating psychiatric disorder in a group of main urban, lower social class, young adults in Jamaica. Methodology used to conduct the study; Results of the study; Information on variables associated with psychiatric disorder; Discussion on the results.

Background: This study aimed to determine the prevalence of psychiatric disorder in young adults with homzygous sickle cell (SS) disease and in controls with normal haemoglobin, and to examine factors associated with psychiatric disorder.Method: The study design was cross-sectional. Subjects were aged 18-20 years: 63 with SS disease and 89 controls. The Psychiatric Assessment Schedule was used to determine psychiatric disorder at index of Definition level 5.Results: Psychiatric disorder was identified in 18 (29%) SS disease patients and in 22 (25%) controls. In SS patients, psychiatric disorder was not related to illness severity but was associated with leaving school early, difficulties in social adjustment, impaired cognitive function and having previous psychiatric difficulties. Male SS patients with psychiatric disorder all had low body mass index (BMI < 17.60). In controls, psychiatric disorder was associated with female gender, unemployment and difficulties in social adjustment.Conclusions: The prevalence of psychiatric disorder was similar in patients and controls, although associated factors tended to be different. The association with low BMI in SS men merits further study. [ABSTRACT FROM AUTHOR]

The authors reflect on the need for a combined approach that influence training of postgraduates and undergraduates in medicine and other caring professions. They mention that re-establishment of cross-disciplinary links between old age psychiatry and geriatric medicine is needed both in clinical practice and professional organisational level. They say that training and education has the potential in improving services for older people having dementia.