Promoting Mental Health and Wellbeing
Introduction
As Collins et al. (2012) note, mental health refers to psychological, emotional, and social well-being. According to Elliott, Huizinga, and Menard (2012), mental health affects how people relate to others; make their choices, and how they handle stress. The state of people’s mental health is important to all stages of life including adulthood, childhood, and adolescence. Once people experience mental health problems, their mood, thinking, and behaviour is affected. Some of the factors that lead to mental health problems include life experiences such as abuse or trauma, biological factors such as brain chemistry and genes, and family history (Collins et al., 2011). The characteristics of mental health and an explanation of the causes are discussed in this paper. On the other hand, wellbeing refers to a satisfactory or good condition of existence. Well-being is mainly characterized by welfare, happiness, and health (Collins et al., 2011).
This paper discusses promoting mental health and wellbeing of old people in the United Kingdom. The main focus is individuals aged more than sixty-five years old. The characteristics of mental health and an explanation of the causes of mental problems are discussed in this paper. Additionally, the wellbeing and mental health of older people aged above sixty-five years are also discussed. For a detailed discussion, the paper also defines and discusses mental health, wellbeing, and their characteristics. Statistics on the age group, mental health conditions, and different interventions at individual and community level that can help to promote mental health and wellbeing. Lastly, an evaluation of the intervention methods is also given through a detailed analysis of literature and statistics.
There has been an increased number of old people with mental problems in the U.K. over the last few decades. As Collins et al. (2010) note, the most common health problem among the old people (aged more than 65 years) is depression. As of 2006, there are more than 2.4 million older people suffering from depression (Michele, 2006). The depression they undergo impairs the quality of their life. It is estimated that the number will increase to about 3.1 million people over the next two decades if action is not taken immediately (Michele, 2006).
Older people have good health and make significant contributions to the economy. For instance, workers aged more than fifty years contribute to more than a quarter of the total national economy. Contributions made by old people who serve as grandparents, careers, and volunteers are £24.2 billion per year (Michele, 2006). The same older people boost the economy by £239 billion a year (Michele, 2006). This shows that mental health and well-being of the elderly is a major point of concern to any given country.
Promoting well-being and mental health of the older people benefits the entire society by maintaining their economic and social contributions, improving the quality of life, and minimizing the costs incurred for their health. However, the factors (such as health issues and economic welfare) affecting well-being and mental health of the older generation have increased (Collins et al., 2011). Therefore, activities that promote the well-being and good mental health of older people should be integrated into national development policies.
Background
There are different terms associated with the increasing number of old people, which vary in contexts. To some people, ageing refers to the process of growing old with time (Collins et al., 2011). In this case, it is defined from a chronological perspective or as a biological process where there is increased cellular and molecular damage which lead to deterioration of function in the long run (Glasby & Tew, 2015). Most statistics on ageing people categorise them as people who are more than 65 years of age (Older people). Individuals above 85 years are known as the ‘oldest old’. The World Health Organisation (2015) defines ‘older people’ as those individuals who have passed the average life expectancy. In the United Kingdom, the average life expectancy for both women and men is 81.2 years (WHO, 2015).
Some of the mental health issues experienced by older people include depression, dementia, anxiety, delirium, and schizophrenia (Glasby & Tew, 2015). Depression in older people may be as a result of isolation and loneliness, illness, physical disability, being divorced, or widowed (Glasby & Tew, 2015; Collins et al., 2015). On the other hand, dementia affects perception, concentration, memory, problem solving, and thinking, while damage of brain cells affects though processes of individuals (Mentalhealth.org.uk, 2016). Other challenges encountered by older people in UK include medication and alcohol abuse, which affect their wellbeing (WHO, 2015).
Categorizing people by their age can be used to understand broad trends, loss of functional ability, and the differences existing between different age groups. According to Glasby and Tew (2015), a decline in functionality is mainly linked to frailty. The British Geriatric Society defines functional decline as a state of health that is related to ageing where several systems of the body lose their functionality (Office for National Statistics: ONS, 2015). Since 1986, the median age of people living in United Kingdom has increased from 35 years to 40 years (Office for National Statistics: ONS, 2015). The proportion of individuals aged more than seventy-five years has increased from 6.5% to 8.0% (ONS, 2015). The current number of older people in United Kingdom is 4.5 million (Age UK. 2016). This is a common trend in most European countries. It is expected that the population of people aged more than 75 years will double in the next three decades. By 2013, life expectancy in UK was 79 for men and 82.5 for women (Age UK, 2016). By 2040, one in every four people will be more than 65 years old (Age UK, 2016).
As noted by Glasby and Tew (2015), wellbeing and mental health of older people in the United Kingdom is identified by discrimination, participation, relationships, health, and income. It is expected that there is no age discrimination which leads to several mental conditions. Older people should participate in social, economic, political, cultural, and civic life (Glasby & Tew, 2015). Ageing people should also have supporting and caring neighbours, friends, and families. It is also expected that older people receive high quality health care services (Glasby & Tew, 2015). Taking such factors into consideration leads to improved well-being and mental health conditions.
However, increase in life expectancy of older people means that there is an increase in the number of years spent on social isolation and poor health since there a several diseases associated with older people. Some of the actions taken to take care of older people include improving retention and recruitment of older people, helping ageing people get online, improvement of local services for ageing people, helping ageing people, helping ageing people at risk of social isolation and long term loneliness to stay active, and supporting councils in the provision of quality life for older people (Glasby & Tew, 2015).
Approximately 36 % of individuals aged more than 65 years in the United Kingdom feel that they are out of touch with life situations in the modern world (Age UK, 2010). Further, 9% of the same age group also feel that they are not actively engaged in the activities carried out in the society. About half of older people (4.6 million) in United Kingdom watch television as their main company. About 600, 000 older people in UK leave their premises once a week (Age UK, 2010). Due to such conditions, older people are not able to engage in meaningful activities or to make good relationships.
In the United Kingdom, the cost of treating diseases and illnesses resulting from health inequality were approximately £5.5 billion per year (Public Health England, 2015). The same statistics recorded that tackling the use of tobacco was estimated to save about £61 million every year. A region such as Newham lost approximately £28–32 billion of higher welfare payments and taxes that resulted from health inequalities (Public Health England, 2015). The money to curb health inequalities could rather be used for other development activities.
Additionally, Beaumont (2013) showed that sixty-six percent of older people in United Kingdom are reported to lead lonely lives, while 25% of people in the people in the same age group were reported to be lonely at times, and 9% were reported to often feel lonely (Public Health England, 2015). A large percentage of people more than 80 years old felt lonely most of their time in comparison to other age groups. Lonely individuals felt a low level of satisfaction in their life while 2 in every five people who lived alone never felt lonely (Beaumont, 2013). Such statistics indicate that older people in UK are facing various challenges with their well-being thus resulting to low quality life.
Interventions at Individual and Community levels
Positive mental health is important because it allows individuals to work productively, realize their potential, cope with their stresses, and contribute positively to the community. Some of the ways of maintaining positive mental health conditions include staying physically active, helping people, getting enough sleep, staying positive, and developing coping skills (Conner et al., 2010). Such things need to be availed to older people to enable them to maintain positive mental health conditions. Some of the interventions that can be taken can cover different aspects such as health, learning, environment, work, parenting, improving relationships, activities, and social inclusion (Jetten, Haslam, and Alexander, 2012).
Five Ways to Wellbeing framework
The five ways to wellbeing include giving, being active, keep learning, taking notice, and connecting (Glasby and Tew, 2015). Giving does not only involve sharing material things with people but also promoting active participation in community and social life, and encouraging people to be generous (Jetten, Haslam, and Alexander, 2012). Community involvement and volunteering is linked with positive functioning and feelings. Helping people, sharing resource and skills, and a behaviour that promotes teamwork help to increase self-worth and cause a positive emotional effect (Mental Health Foundation, 2015). Giving is not only important to older people but also all age groups because it helps people to develop social recognition in adolescents and children, self-worth in adults, and a sense of purpose.
There is a strong connection between well-being and physical activity, as well as reduced rates of anxiety and depression. Physical activity is essential for all age groups because it slows down age-related challenges (Mental Health Foundation, 2015). Physical activities increase self-belief, the ability of coping with adverse situations, and providing mastery. Staying active also encourages social interactions which tend to reduce depression and anxiety (Brown, Learmouth, and Mackereh 2014). Individuals do not have to be highly vigorous in physical activities; moderate engagement in physical activities also leads to reduced depression (Brown, Learmouth, and Mackereh 2014).
Setting goals, remaining curious and learning is important for all age groups. For children, learning leads to social development and positive cognition while in older people, it leads to increased social interactions, improved self-esteem, and staying involved in life (Jetten, Haslam, and Alexander, 2012. Learning in adults includes goal-setting which results to well-being (Mental Health Foundation, 2015). Well-being in this case is increased when individuals are positively focused, when their goals are self-generated, and when the goals align with personal values (Brown et al., 2014). Learning does not only involve formal education but other approaches in life that maintain an enquiring mind and curiosity.
Development of skills that tend to increase awareness both mentally and physically in people improves well-being. For instance, Sharma, Atri, and Bransuem, (2013) showed that short courses that do not teach complex techniques can enhance well-being in older people. Mindfulness has positive effects that increase self-knowledge. Being open minded helps to choose behaviours that are in line with people’s values, needs, and interests. Staying aligned to personal values ensures that there is change of behaviour (Sharma, Atri, & Bransuem, 2013). Approaches that enhance well-being include forgiveness, gratitude, and development of meaning.
Being valued by people and feeling close to them is a fundamental for a person’s wellbeing. Being connected to people is fundamental across all relationships and ages in life. The feeling of connection is important for well-being and prevents possible mental disorders (Sharma, Atri, & Bransuem, 2013). Helpful social relationships are meaningful, encouraging, and supportive because they create a wide social network which is helpful to people because it creates a sense of self-worth (Sharma, Atri, & Bransuem, 2013). Connecting with people involves giving space and time to broaden and strengthen social networks. The wellbeing of people is also bound to that of their communities (Sharma et al., 2013). Measures that are aimed at inward-looking benefits may not be as effective as those aimed at an entire community.
Physical Activities and Social Inclusion
Older people should be engaged in physical activities such as jogging and walking. According to Mitchell (2013), people carrying out physical activities have high levels of satisfaction. Such activities can be done by forming exercising groups of more than two people who can conduct the activities daily or a specific number of times in a week. The activities can also be conducted in the morning or in the evening. Jogging or walking could take up to thirty minutes depending on age and the physical health of individuals concerned (Gasby and Tew 2015). Older people can also be encouraged to walk around during day time. They can also be encouraged to visit places and friends to avoid staying dormant and idle. Such activities create positive moods that make them feel sociable (Brown et al., 2014). They also enjoy the company of other people if the physical activities are carried out in groups.
Social networks are important tools of building resilience in people. At community levels, people with high resilience have a strong attachment to their surrounding which is determined by social networks (Sharma, Atri, & Bransuem, 2013). Older people should be provided with social support during or before adverse circumstances. The social support given to them by neighbours and their families increases their resilience (Jetten, Haslam, and Alexander, 2012). For instance, when they feel sick or depressed, people should stay close to them to talk to them, to help solve their problems, or to even talk about the challenges faced.
Social inclusion also refers to how older people are able to access opportunities (Sharma et al. 2012). Policies that reduce inequality and those that promote antidiscrimination should be put in place. Conner et al. (2015) asserts that older people can also be engaged in arts projects which tend to improve their confidence, give them self-determination, and empower their communities. Such activities create social cohesion and enhance their perceptions of the surrounding (Sharma et al., 2013). Arts projects that lay emphasis on creativity, self-expression, and well-being help to improve people’s relationships and neighbourhoods.
Older people should be encouraged to form self-help groups and lunch clubs where they can interact with each other and talk about the issues they face (WHO, 2015). Such groups can also help them to discuss helpful ideas thus enhancing their creativity. Such community activities are more beneficial than individual interventions that may engage them in telephone conversations. Communal interventions of well-being improve social functioning (Naidoo and Wills, 2016). Befriending older people helps to tackle depression, tackling isolation, and improving their well-being.
Advantage of Social Inclusion and Physical Activities (Naidoo and Wills, 2016)
- They are cost effective measures. For instance, it only takes word of mouth to engage people in social activities.
- The method is easy to implement because people have all what it takes to start immediately.
- Social connections are improved in the process of conducting physical activities.
Disadvantages of Social Inclusion and Physical Activities (Naidoo and Wills, 2016)
- It may be costly to construct training fields and facilities if they are not readily available.
- Some individuals may not take the activities seriously.
Reducing Discrimination and Stigma
Anti-stigma campaigns conducted by the local community should be carried out quite often in different places. Public awareness of issues affecting older people and how they should be taken care of needs to be conducted. Anti-stigma campaigns should help those suffering from depression to feel relieved through engagement in social activities (Lasalvia et al. 2013). There should be direct contact between the sick older people and the general public to enable them feel accepted. Acceptance helps them to feel good about themselves and others.
Nurturing self-esteem and confidence of older people involves encouraging them to learn new things, to explore and to take next steps in life (Conner et al., 2010). They should not feel that they are too old to do certain activities. Encouraging them to take part in various community development projects reduces discrimination against them. Older people should also be provided a safe environment to help build their self-esteem and self-confidence (Conner et al., 2010). Such people should also be encouraged when they fail to reach their goals. Sarcasm and criticism should be avoided at all costs.
Advantages
- It is easy to start and implement.
- It is a relatively cheap way of educating people.
- A large number of individuals are reached within a short time (Conner et al., 2010).
Disadvantages
- It may be targeted at individuals thus it may take time to achieve the desired results.
- A large number of activists are required thus increasing the costs incurred (Conner et al., 2010).
Reduction of Mental Health Problems and Increased Learning at Work
Mental health programs should be encouraged. Such programs involve providing well-being and personalized information. Barry and Jenkins (2007) posit that older people should be engaged in such programs to educate them of how they can take care of their mental health and how they can maintain their well-being. Questionnaires can also be administered at places of work to understand the current mental health problems faced by the elderly. Another helpful activity is providing free access to tailored health improvement services that enable them to learn more about the way they should live in their later years to avoid depression or stress (Gasby and Tew, 2015).
Workshops and wellness literature workshops should be conducted regularly. The activities should be focused on identifying wellness issues and educating older people on healthy ways of living (Beckett & Taylor, 2010). The workshops and seminars can also challenge them to take part in learning activities and social involvement. Seminars and other public gatherings lower stress levels of individuals because they do not feel lonely. Other important measures would be enhancing working conditions (Beckett & Taylor, 2010). When people grow old in a work place, they should be given tasks that they can easily handle so as to keep them motivated.
Advantages
- It is effective because it can be incorporated in daily or regular routines.
- It reaches a large number of working individuals (Beckett & Taylor, 2010).
Disadvantages
- Only working individuals are reached.
- It may be expensive to hire trainers and health professionals regularly (Beckett & Taylor, 2010).
Evaluation
Evaluation refers to the process of critically examining a program. It basically involves analysing and collecting information about the outcomes, activities, and characteristics of a program. Evaluation is aimed at judging a program, improving its effectiveness, and informing different decisions. The interventions discussed in this paper could be evaluated by counting the number of people who engage in the programs and determining the number of people who improve their mental health conditions. An increased number of activities in different regions also means that the activities aimed at promoting well-being and mental health are taken seriously.
Conclusion
There is high rate of increase in older people living in the United Kingdom. The population of older people is expected to double in two decades. There are various mental health and well-being issues associated with older people living in the UK. Depression, dementia, discrimination, and stress are some of the problems they face. Five ways to wellbeing include giving, being active, keep learning, taking notice, and connecting. Some of the possible ways of solving the problem include social inclusion, increased physical activities, reducing discrimination and stigma, and reduction of mental health problems, and increased learning at work. Due to the increased life expectancy rate of people living in UK with time, it is expected that mental health programs and problems will increase in future. The UK government should set more funds aside to address mental health and well-being issues among older people.
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