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The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire studies that examined the experience of consultants in old age psychiatry and consultants in other psychiatric specialities in the early implementation of the MCA pertaining to issues relevant to black and minority ethnic (BME) groups. Fifty‐two (27%) of the 196 consultants in old age psychiatry and 113 (12%) of the 955 consultants in other psychiatric specialities returned useable questionnaires. Eighty per cent or more of the consultants in old age psychiatry and consultants in other psychiatric specialities gave consideration to religion and culture and ethnicity in the assessment of decision‐making capacity (DMC). Almost 50% of the consultants in old age psychiatry reported that half or more of the patients lacking fluency in English or where English was not their first language received an assessment of DMC with the aid of an interpreter and 40% of the consultants in other psychiatric specialities reported that no such patients received an assessment of DMC with the aid of an interpreter.The low rate of using interpreters is of concern. The nature of the consideration and implementation of factors relevant to culture, ethnicity and religion in the application of the MCA and the precise reasons for the low rate of using interpreters in patients lacking fluency in English or English not being their first language require clarification in further studies.

The Royal College of Psychiatrists set up an interface group to look at the interface between old age psychiatry and learning disability and, as part of its work, the group commissioned a survey of learning disability and old age psychiatrists to investigate their experience of working across the boundary between the two specialities. This paper is based on the report produced. It summarises the findings of the survey and sets out eight recommendations to further the work. There was no clarity on how services should be provided to older people with a learning disability who develop a mental health problem in later life but the need for collaboration between the two specialities is compelling.

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 Faculty of Old Age Psychiatry, Royal College of Psychiatrists, has been involving users and carers in its work since 2002. The model that has been developed involves regular meetings of a consumer group, which was set up in partnership with the Alzheimer's Society and Age Concern, and which meets with the officers of the faculty. This development is in line with a number of recent policy initiatives and has had considerable influence on the work of the faculty.

The aim was to determine the number of referrals of people aged 55 and over to three forensic and psychiatric intensive care unit (PICU) services in Scotland, and to describe their demographic, criminological and psychiatric characteristics. Of a total of 1838 referrals, 63 (3.4%) were aged 55 and over. Of these, 35 were referred for court reports or prison assessment and half had been charged with violent or sexual offences. Most were diagnosed as suffering from a psychiatric disorder at the time of assessment, 11 (31.4%) were admitted for further assessment. There were a further 28 admissions to PICU beds. Older adults form a small but important minority of referrals to forensic and PICU services. A single case register would aid further study in this area. Further exploration of the clinical needs of these patients would be useful.

The purpose of this paper is to systematically appraise the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health.

The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors found in previous reviews that a substantial number of papers from developing and non-English speaking countries are published in journals not indexed in mainstream databases, and devised a search strategy using Google which identified a number of papers, which could not be found when the search was limited to scientific data bases only (Farooq et al., 2009). The strategy was considered especially important for this review which focuses on communication across many different languages. Thus, the authors conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. The authors also searched the reference lists of included and excluded studies for additional relevant papers. Bibliographies of systematic review articles published in the last five years were also examined to identify pertinent studies.

Only four publications related specifically to “old age” and 33 addressed “interpreting” and “psychiatry” generally. Four articles presented original research (Parnes and Westfall, 2003; Hasset and George, 2002; Sadavoy et al., 2004; Van de Mieroop et al., 2012). One article (Shah, 1997) reports an “anecdotal descriptive account” of interviewing elderly people from ethnic backgrounds in a psychogeriatric service in Melbourne and does not report any data. Therefore, only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. One is a quantitative study from Australia (Hasset and George, 2002), the second is a qualitative study from Canada (Sadavoy et al., 2004), in the third paper Van de Mieroop et al. (2012) describe community interpreting in a Belgian old home and the final paper is an American case study (Parnes and Westfall, 2003).

Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics.

The literature on working through interpreters is limited to a few empirical studies. This has serious consequences for service users such as lack of trust in services, clinical errors and neglect of human rights. Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK, unlike Sweden (see www.regeringen.se/sb/d/3288/a/19564). This omission is disturbing – especially when decisions on human rights are being considered as part of the Mental Health Act. Such a standard can best be achieved by collaboration between medical profession and linguists’ professional associations (Cambridge et al., 2012).

Whilst translation/interpretation has been addressed more generally in mental health: specific considerations related to old age psychiatry are almost absent. This needs urgent rectification given that a large proportion of older people from BME communities will require translation and interpretation services.

Suicide is a tragic cause of death and causes considerable distress for families, carers and healthcare professionals. Thankfully, suicide rates in older people in the UK have steadily declined for both men and women since the mid‐1980s. An understanding of the clinical and demographic characteristics of both completed suicide and non‐fatal self‐harm in older people is important in informing the development of preventative strategies to sustain this decline. Non‐fatal self‐harm in older people is relatively uncommon compared with younger age groups, but research indicates that self‐harm among older people is frequently a failed attempt at suicide. Thus, the important factors associated with self‐harm in this age group are similar to those linked with completed suicide, particularly high rates of clinical depression, poor physical health and social isolation. Unfortunately, there is also a high rate of subsequent completed suicide. For this reason, self‐harm in later life needs to be taken very seriously and a careful assessment of risk and need by a specialist in older people's mental health should be conducted. The identification and appropriate management of older people with depression in the community and general hospitals is a key area for the prevention of self‐harm and suicide in this age group and requires further attention, particularly with targeted support programmes for those at high risk.

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 purpose of this paper is to detail developments in UK alcohol policy for older people over the past 20 years, based on evidence for a growing public health problem with alcohol misuse in older people.

A literature search was carried out using health and social care databases, including grey literature.

There has been considerable progress in areas such as screening and brief intervention, low-risk drinking and service provision for integrated care in older people with dual diagnosis.

There remains a dearth of research and policy for older people with alcohol misuse and dual diagnosis prior to 2011. Although there remains limited empirical evidence for public health interventions to improve health outcomes from alcohol-related harm, improvements in population health from implementation of recent policy changes and intervention programmes remains to be seen.

This review has implications for best practice in the provision of integrated care to reduce harm and improve health and social outcomes in older people with alcohol misuse and dual diagnosis.

This review draws together a large area of research and policy on alcohol misuse in older people that has the potential to improve public mental health for older people who are at risk of alcohol-related harm.