Supporting the management of mental health problems among older adults: Where does the Fire and Rescue Service fit in an integrated world?

Conference:

SAPC ASM 2023 - Brighton

Talk Code:

2D.7

Presenter:

Tamsin Fisher

Twitter:

@FisherResearch

Co-authors:

Carolyn A. Chew-Graham, Nadia Corp, Saeed Farooq, Paul Kingston, Ian Read, Jane Southam, Gary Spolander, Dean Stevens, Carmel Warren, Tom Kingstone

Author institutions:

Keele University, University of Chester, Robert Gordon University, Staffordshire Fire and Rescue Service, Midlands Partnership NHS Foundation Trust

Problem

Depression and anxiety in older adults (aged 60 years and over) are often under-diagnosed and under-treated. Older adults may be excluded from mental health services due to perceived stigma, lack of awareness, fear of being a burden and lack of access to services. Non-traditional providers of healthcare, such as the Fire and Rescue Service (FRS), may provide one solution through existing outreach roles to support early detection of mental health problems and facilitate help-seeking among older adults. The FRS has been utilised by primary and social care to support members of the public in times of emergency and/or crisis (e.g. Covid-19 vaccination programmes). We aimed to examine whether and how FRS ‘Safe & Well’ visits can be optimized to include detection of, and sign-posting for, anxiety and depression in older people.

Approach

Multi-method qualitative study to establish an in-depth, contextual understanding of the role of the FRS in the integrated healthcare of older adults with anxiety and/or depression. 17 interviews were conducted with health and social care stakeholders (GPs, social workers and community matrons) across one UK region to understand perceptions about the potential role of the FRS in mental health care (specifically anxiety and depression), expanding current outreach activities to include identification of possible mental health problems and signposting or referring older adults who might be experiencing anxiety and/or depression. Data analysed using Braun and Clarke’s thematic approach. The research has been informed by patient and public involvement contributors throughout. Ethical approval sought from Keele University.

Findings

Health and Social Care (HSC) stakeholders agreed that, whilst not traditionally associated with mental health care, the FRS could and should detect anxiety and depression in older adults and signpost as necessary. Analysis identified two overarching themes: Acceptability and Capacity. All HSC stakeholders felt it was acceptable, even expected, for the FRS to detect and signpost people who might have anxiety and depression; however, some emphasized the need for sufficient training. Through their existing roles, the FRS have the opportunity to access properties and work with members of the public that other services do not; they can provide an ‘extra pair of eyes’ on a potentially at risk population. Some HSC stakeholders raised concerns for a potential increase in FRS referrals into an already overwhelmed care system.

Consequences

It is acceptable for HSC stakeholders that FRS staff should identify and signpost vulnerable older adults living with anxiety and depression to support their access to other services. Stakeholders recognised that FRS need training for this role. The views of FRS and older adults have been sought in other data collection activities. Multi-stakeholder workshops are planned to support design and development of a new training intervention for FRS staff.

Submitted by:

Tamsin Fisher

Funding acknowledgement:

This study is funded by the NIHR [Research for Patient Benefit (NIHR:201967)]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.