Old age psychiatry

Old age psychiatrists (OAP) are doctors who provide assessment, treatment and continuing care for older adults with a range of mental health problems including dementia and other disorders including depression and schizophrenia.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Download transcript

In this video Dr Alex Bailey, Consultant old age psychiatrist, gives an insight into his working life and also the nature of the demands and rewards that come from working in the community with elderly people and the type of person that it would suit as a career.

You can also watch a video of Sarah, a trainee in old age psychiatry, talking about her experiences.

Nature of the work

Mental health problems in older people are increasingly being recognised as a major health issue. Increased life expectation in recent years has resulted in a growing demand for old age psychiatry services. Dementia care and memory problems are a significant aspect of the work. Depression is also common in older people. Many other mental health problems across the spectrum of psychiatric illness including delirium, schizophrenia and personality disorder are also treated. About 50% of the work is non-dementia.

In the past old age psychiatrists worked with people over the age of 65. However, this is no longer always true and younger people suffering from dementia/memory problems may also be seen. Working with patients’ families is an important and interesting aspect of the work. Person-centred care, embracing independence and choice are at the heart of old age psychiatry.

Mental health and social problems in old age are closely related. This means that old age psychiatrists need to collaborate closely with many different agencies including GPs, social services, occupational therapy and voluntary agencies. Nowadays, there is a strong emphasis on community care and delivering interventions and care packages that enable older people to stay in their own homes. Other priorities include developing memory services and improving acute in-patient services.

Physical problems also affect mental health and this respect a holistic approach is important.

Old age psychiatrists need an understanding of the legal and philosophical issues regarding protection of individuals’ human rights, end of life decisions, capacity, informed consent and mental health legislation. Clinical decisions are always balanced with ethics.

Old age psychiatry services may be provided in acute general hospitals as well as in community settings including residential and nursing facilities.

Common procedures/interventions

Assessing patients is a very important aspect of the work. There is a growing demand for cognitive assessments for patients with memory loss and cognitive impairment. Both assessments and follow-up may be carried out in the patient’s home.

Patients may present with organic disorders (such as memory loss) as well as functional disorders (such as depression or psychosis). They may also have multiple physical and social issues. The work therefore often involves the assessment of patients with complex issues.

Treatments can involve medications, talking therapies or a combination of the two. Accurately prescribing and monitoring appropriate medication is an important part of the role. Old age psychiatrists need a detailed knowledge of the way in which older people metabolise drugs, since this can change as part of the aging process.

Talking therapies such as cognitive behaviour therapy may be provided by the old age psychiatrists themselves, or they may refer patients to a therapist or clinical psychologist who provides the treatment.

Old age psychiatrists may also be required to treat patients who are subject to the legal framework provided by the Mental Health and the Mental Capacity Acts. They may be detained against their will under a “section” or may not be able to make some or all of their own decisions.

Want to learn more?

Find out more about:

Other roles that may interest you

Is there anything wrong with this page?

Help us improve Health Careers

If you would like us to recontact you about the issue, make sure you are logged in before submitting.