title: Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy.
abstract: OBJECTIVE
  This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age
  
  
  METHODS
  Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7.
  
  
  RESULTS
  A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14 425 (20%) respondents. A total of 122 740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy.
  
  
  CONCLUSIONS
  Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people.
authors.affiliation: Centre for Quality Improvement, Royal College of Psychiatrists, London, UK; Oxford Health Foundation NHS Trust, Oxford, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Chaplin
authors.forename: Lorna
authors.initials: L
authors.lastname: Farquharson
authors.forename: Melissa
authors.initials: M
authors.lastname: Clapp
authors.forename: Mike
authors.initials: M
authors.lastname: Crawford
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D054869:Clinical Audit; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
keywords: audit; clinical outcomes; older adults; psychological therapy