Severe mental illness and ageing
Severe mental illness and ageing: coordinate physical checks, medicine reviews, crisis planning and community support with the person in control.
How this guide was prepared
Purpose: urgent guidance · Level: detailed
Checked by: Does Your Duck Quack. Sources are linked below; seek professional advice for individual circumstances.
The short answer
What to do first
Severe mental illness and ageing: coordinate physical checks, medicine reviews, crisis planning and community support with the person in control.
Start here: Ask whether the GP, community mental-health team, psychiatrist or older-adult service is the main contact. Record each team’s role and how information may be shared with consent. After a move or discharge, confirm who arranges follow-up.
Do not wait: If someone is thinking about suicide or may act on it, call 999 or go to A&E. Samaritans is available 24 hours a day on 116 123. For urgent NHS mental-health help: in England call 111 and choose the mental-health option (option 2 where prompted); in Wales call 111 and press 2; in Scotland call NHS 24 on 111; in Northern Ireland call Lifeline on 0808 808 8000. If danger is immediate, use 999 rather than waiting for a helpline.
Scope of this guide
This guide helps you understand the options and questions to ask. It is not personal medical, legal or financial advice. Check the official sources for your nation and seek qualified help for high-stakes decisions.
Call 999 for a life-threatening emergency. For an urgent problem that is not clearly life-threatening, use the official NHS urgent-care route for the UK nation you are in. Have the address, symptoms, onset time, medicines and allergies ready.
Who this guide is for
Older adults living with schizophrenia, bipolar disorder or psychosis, and carers who want physical and mental healthcare coordinated.
A long-term mental-health condition does not become less important with age, and new physical symptoms should not automatically be attributed to it. People living with schizophrenia, bipolar disorder or psychosis may have several teams involved, changing routines and medicine effects to discuss. Care works better when the person’s own goals, physical health, relationships and crisis preferences are considered together.
What to do now
1. Agree who is coordinating care
Ask whether the GP, community mental-health team, psychiatrist or older-adult service is the main contact. Record each team’s role and how information may be shared with consent. After a move or discharge, confirm who arranges follow-up.
2. Ask about physical-health monitoring
In England, NHS guidance describes an annual physical-health check for people on the SMI register, including schizophrenia, bipolar disorder or psychosis. Ask the GP practice how to arrange it. Elsewhere, ask the GP and mental-health team what monitoring applies.
3. Discuss medicines and new symptoms safely
Ask the prescriber or pharmacist to review medicine purpose, effects and monitoring. Mention falls, dizziness, sleep, appetite, constipation, pain or difficulty taking treatment. Do not stop or change medicines without advice. New physical symptoms still need assessment.
4. Write a crisis plan with the person
Write early warning signs, helpful responses, preferred contacts and the person’s choices about crisis support. Include current urgent numbers and keep a copy accessible. Share only with people the person chooses unless a lawful safety reason applies.
5. Include carers without displacing the person
Ask what help the person wants with appointments, transport or reminders. A diagnosis does not remove their right to decide. Carers can request support for themselves. If someone may act on suicidal thoughts or is in immediate danger, call 999 or go to A&E.
Warning signs and checks
- Physical-health checks completed
- Medicine monitoring current
- Relapse plan available
- Capacity considered specifically
- Housing and social needs reviewed
- Urgent contacts known
- The care coordinator and contact details are clear.
- Physical symptoms are assessed on their own merits.
- The crisis plan reflects the person’s preferences and is current.
Common questions
Can older people with schizophrenia or bipolar disorder get an annual health check?
NHS England guidance describes a comprehensive annual physical-health check for people on the SMI register, including schizophrenia, bipolar disorder and other psychosis. Ask the GP practice whether the person is on the register. Scotland, Wales and Northern Ireland arrange monitoring differently, so ask locally.
Who should I contact if symptoms are getting worse?
Follow the crisis plan and contact the named mental-health team, care coordinator or GP. For urgent help use the nation’s NHS crisis route. Call 999 or go to A&E if there is immediate danger or someone may act on suicidal thoughts.
How can family support without taking over?
Ask what help the person wants and what information may be shared. A relative can help with transport, reminders or questions, but diagnosis alone does not remove decision-making rights. Ask about a carer’s assessment if support is affecting your own health.
Differences across the UK
Mental-health teams, crisis services and routine physical-health monitoring are organised differently in England, Scotland, Wales and Northern Ireland. England has NHS guidance for an annual SMI physical-health check; elsewhere, ask the GP practice and community mental-health team which checks and recall arrangements apply. Urgent crisis routes also differ. A person with a care plan should keep its local contact details current; use 999 if someone is in immediate danger.
If someone is thinking about suicide or may act on it, call 999 or go to A&E. Samaritans is available 24 hours a day on 116 123. For urgent NHS mental-health help: in England call 111 and choose the mental-health option (option 2 where prompted); in Wales call 111 and press 2; in Scotland call NHS 24 on 111; in Northern Ireland call Lifeline on 0808 808 8000. If danger is immediate, use 999 rather than waiting for a helpline.
Primary sources
The publisher checked this guide against the 11 official sources below. This is an editorial source check, not approval by a clinician, lawyer or benefits adviser.
- NHS: Mental health services
- NHS England: Physical health and severe mental illness
- NHS Trust: NHS 111 option 2 for urgent mental-health support
- NHS: Annual health check for severe mental health conditions
- NHS England: Improving physical health in severe mental illness
- NHS: Where to get urgent mental-health help
- NHS inform: Get urgent mental-health help in Scotland
- GOV.WALES: NHS 111 press 2
- nidirect: Mental health emergency
- Samaritans: Talk to us by phone
- GOV.UK: 999 and 112 emergency numbers
Related guides
Editorial note: By Does Your Duck Quack.