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The black and ethnic minority (BME) elderly population in England and Wales is increasing. As dementia is an age‐related disorder and the prevalence of depression in old age is high, the absolute number of cases of dementia and depression will increase among BME elders. This has implications for the development and delivery of old age psychiatry services (OAPSs) for BME elders. Demographic data pertaining to the elderly from BME groups in the 2001 population census were analysed in detail to evaluate the implications for development and delivery of OAPSs for BME elders. The demographic changes identified have important future implications for the development and delivery of OAPSs for BME elders. Unless they are addressed systematically, BME elders will continue to harbour untreated, hidden psychiatric morbidity. Strategies to ensure that this vulnerable group of elderly are identified and provided with accessible, acceptable and culturally sensitive OAPSs should be developed.

The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression among BME elders from different groups in the United Kingdom is generally similar to or higher than in indigenous white British elders. Two methods were used to provide a conservative estimate of the absolute number of cases of dementia and depression among BME elders. Data on prevalence from published studies of different BME elderly groups and the number of those over the age of 65 years from different BME groups in the general population in the 2001 population census were used for analysis. The most conservative estimates of the absolute number of cases of dementia among BME elders were 7270 and 10,786 for the two methods of analysis; the corresponding figures for depression were 33,559 and 52,980. There is a significant amount of psychiatric morbidity among the elderly from BME groups. A multi‐faceted approach is needed to ensure that commissioning, design, development and delivery of culturally capable, appropriate and sensitive old age psychiatry actually occurs and improves the equity of service access by BME elders.

We describe three homeless older people who presented to an old age psychiatry service. Homeless older adults are likely to have untreated mental and physical health problems and to be invisible to services. To detect and treat them, services need to be flexible.

The provision of a seamless service to address the needs of older people with substance misuse is now more pressing than ever, particularly given the impact of a growing population of older people in society, and with co‐morbid mental health and substance use issues. There is growing recognition of the public health needs of older people with mental health problems and substance misuse. This paper seeks to consider the development and implementation of one particular dual diagnosis strategy.

The paper examines the background, development and implementation of a dual diagnosis strategy designed to address the growing problem of substance misuse of older people in an inner city area in London, UK.

A needs assessment highlighted workforce training needs which led to the commissioning of innovative training to address this. Pathways were created to allow seamless transition between services, thus enabling older adults with dual diagnosis to receive the care that they required.

Most local dual diagnosis strategies have focused on adults of working age. This paper concentrates on a local strategy aimed at improving services for older people with mental health and substance misuse problems.

The purpose of this study was to examine the literature surrounding dementia in the aging correctional population and assess the role of cognitive screening related to dementia detection within corrections. The literature regarding the role of dementia within the justice continuum is scant. Furthermore, correctional health researchers have not reached a consensus on the best age to administer cognitive screening in older persons or prioritizes a screening tool for the early detection of dementia.

A key search term list including dementia screening and was developed to review the literature surrounding dementia and the aging correctional population. PubMed, Criminal Justice Abstracts (Ebsco) and the National Criminal Justice Reference Service were used within the academic search. A gray literature search using these same search terms was conducted reviewing criminal justice federal agencies and organizations for additional information on the dementia experience within correctional settings. Snowballing was used to capture relevant theoretical and empirical knowledge.

Shortages in aging specialized health-care staffing presents a barrier for the clinical interpretation of Montreal Cognitive Assessment (MoCA) results. Correctional officers are also identified as useful candidates within the administration of cognitive screening with proper training. The MoCA may be the optimal cognitive screening tool for dementia, until an original cognitive screening tool is created specific to the correctional population. An age of 55 years or older may serve as the best cutoff score for classifying incarcerated individuals as older persons, and screening should be prioritized for these individuals. Finally, new specialized programs related to dementia within correctional settings are identified.

A limitation of this research is the conflicting opinions among researchers regarding the use of general cognitive screening tools within the correctional setting.

This research can inform correctional organizational policy and practices regarding the screening of older persons suspected of dementia. Most notably, this research proposes that correctional settings should incorporate the MoCA within initial screening of all individuals 55 years of age or older, enriching the job design of correctional officer's job positions to include cognitive testing, and for correctional settings to provide dementia and age-associated training for correctional officers. Finally, this paper informs future research in the development of a cognitive assessment tool specific to the correctional population.

This paper considers the doctor's role in unravelling the causes of abuse of older people. The author argues that doctors have a responsibility to understand and address the ageism, ignorance and unthinking which lies is at the root of most institutional abuse.

The National Institute of Mental Health England (NIMHE) appointed a Fellow in Ageing and Mental Health to take on a national leadership role for a three‐year period from 2003 to 2006. Starting from a position where the NIMHE website could only address older adult issues under social exclusion, a group of committed individuals in a range of organisations came together and a regional and national work programme in older people's mental health was developed. This paper offers reflections on the issues raised during the Fellowship in respect of older people's mental health services and this Fellowship model of leadership.

Suicide can be an emotive, and at times, controversial subject. The purpose of this paper is to reflect on the social, health, personal, and cultural issues that can arise in later life and the potential reasons for suicide. It will analyse already recognised risk factors of suicide in older adults and focus on improving knowledge about the social meaning and causation of suicide for older people. It will also consider suicide prevention policies, their practice implications, and whether they are successful in protecting this potentially vulnerable cohort.

A synopsis of available literature in the form of a general review paper of suicide of older adults.

There is evidence that the ageing process often leads to a set of co-morbidities and a complex and diverse set of individual challenges. This in turn equates to an increased risk of suicide. There is no easy answer to why there is evidence of a growing number of older adults deciding that suicide is there only option, and even fewer suggestions on how to manage this risk.

The entry of the “baby boom” generation into retirement will lead to the potential of an increase in both suicide risk factors and older adults completing suicide. This is on the background of a demographic surge which is likely to place additional pressures on already under-resourced, and undervalued, statutory and non-statutory services.

A literature search found very little information regarding older adults and suicide risk, assessment, treatment or prevention.

There are substantive gaps in the literature in relation to older women in prison This chapter will utilise the risk, need and responsivity framework to develop a more comprehensive understanding of the characteristics attributable to this small but significant group. To date most research into the experiences of older women in prison consist of relatively small-scale qualitative research. Wahidin (2004) argues that this group may have been overlooked and broadly neglected because of a latent form of ageism which has served to permit organisational oversight (p. 10). While others reflect on the difficulties posed by such small numbers and subsequent lack of statistical power resulting in a dearth of research (Omolade, 2014).

Britton and Jensen (2003, p. 2) emphasised a well-documented dichotomy when they stated that a ‘women’s violence stands in stark contradiction to prevailing norms around (white) femininity’. For older women, a crude lack of intersectionality and denial of reality is combined with the systemic male bias of the criminal justice system (Kerr & Shackel, 2018), limited acknowledgement of variability (Chrisler & Palatino, 2016) and how these factors are considered in terms of risk, need and responsivity (Wilson-Smith & Carr, 2017).

This chapter will utilise these considerations as a foundation together with theoretical underpinnings of development, socialisation and incarceration, in order to further develop knowledge while emphasising the hidden challenges of older women in prison and identifying areas requiring urgent development.