PITCH: What are frail older people’s priorities for future mental health research? A Public Engagement Project.

Problem

There is a high volume of research into later life and frailty, but frail older people typically get fewer chances to have their say in what research is important to them. We aimed to engage with older people attending day centres to find out what was important for wellbeing in later life and how it could be improved.

Approach

We organised four discussion groups and two photo projects at two days centres in London and Hertfordshire, involving 29 service users in total. For the photo project, we provided disposable cameras to service users to take photographs of things they felt improved wellbeing, which we then used to create interactive photo displays as discussion points.

Findings

Service users found it difficult to articulate how they felt, and to discuss hypothetical future research ideas. We therefore personalised the discussions to focus on people’s own experiences and what they felt might be helpful. They reported that feeling low or anxious was often due to an accumulation of many events in their life (such as bereavement, loneliness, feeling unsafe, physical illness) with no clear trigger. ‘Talking about it’ was viewed as generally helpful but not necessarily a cure, with depression being something that you had to get over yourself.

Activities that promote getting out regularly, such as day centres, gardening and shopping, were viewed positively and considered a good distraction from feeling low. Access to support from friends and family, as well as more practical support with things like finances, were also considered helpful. Antidepressants had mixed views and people felt it was important to be able to exercise control over use of these. For some, low mood was a lower priority than other issues, such as physical difficulties. Other factors that were important to service users included having good memories, feeling safe, having good carers and pets. Services, such as AgeUK, were considered more suitable for practical issues rather than wellbeing support.

Consequences

Our engagement work highlighted that although frail older people are aware of the prevalence and effects of depression in themselves and their peer groups, they were unsure whether and how it might be effectively treated. Future research should reflect the importance of viewing depression in the context of multiple events occurring in a frail older person’s life and providing a range of treatment options to suit the individual preferences of service users.