ABSTRACT
Expectations about quality and levels of care have risen progressively since the National Health Service (NHS) was founded almost 60 years ago. Rising national wealth combined with a rising proportion of that wealth being spent on health through the NHS have addressed these demands, but there remain significant pressure points particularly in mental health services for the third age. There are increasing expectations of choice enshrined in the language of autonomy and supported by the Human Rights Act and the Mental Capacity Act. The marginalisation of older people’s mental health in the context of national developments of mental health strategy or within older people’s health provision is so consistent throughout all levels of planning that it appears to represent an unconscious form of institutional ageism. Much of the additional spending on mental health that has occurred in the past few years has gone into providing high-quality care for offenders with mental health problems.
