Health Promotion Report: Mental Health and Wellbeing in Elderly, UK

This report delves into health promotion strategies specifically tailored for the elderly population, focusing on mental health and wellbeing within the UK context. It begins by defining health promotion and its practical applications, particularly in addressing the mental health challenges faced by ol...Read More

Health Promotion

Table of contents
INTRODUCTION...........................................................................................................................1
Practical aspects for health promotion.........................................................................................1
BEHAVIOR THEORY...................................................................................................................2
Health Belief Model....................................................................................................................2
Critical assessment of the impact of attitudes towards health, well-being and health promotion
.....................................................................................................................................................3
Population-wide versus targeted health promotion interventions...............................................4
Strategic and Action Plan for Health Promotion.........................................................................5
Impact of inequalities on health promotion planning and practice..............................................6
Ethical and political issues in relation to health promotion.........................................................7
Tools for Assessing Community Health Needs...........................................................................7
Planning Health Promotion Activities, Using Participatory Methodologies That Engage
Communities................................................................................................................................8
Models of community organization and development and their application to health promotion
practice.........................................................................................................................................8
Examining The Pitfalls of Participatory Processes......................................................................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Health promotion encompasses the process that enables people to improve their health by
empowering them to gain control over their health aspects. This is an important concept as it
aims to improve the health status of not only individuals and families, but also of the
communities, states as well as overall nations (McDaid and et.al., 2017). In this way, it assists in
enhancing the quality of life of people thereby preventing premature deaths. The present report
focuses on health promotion intervention in the area of mental health and wellbeing in elderly
people. According to World Health Organization (WHO) 6 percent of the total disability in the
elderly group is because of the mental disorders. In the world, the percentage elderly people
suffering from a mental disorder is approximately 15 percent (Mental health of older adults,
2021). In the UK, it is expected that the number of people of 75 years of age or more will
approximately double in the next 10 years (The ageing population: Numbers and Statistics,
2018). This indicates the necessity to plan a health promotion intervention regarding the mental
health and wellbeing in elderly. In the present report, strategic and action plan for health
promotion have been presented. Behavioral theory has also been discussed in relation to the
chosen area and the chosen group of people. Lastly, the project provides tools for assessing
community health needs.
Practical aspects for health promotion
The efforts regarding health promotion can be targeted on the health conditions with have
become a priority. This involves considering large population and promoting multiple
interventions. It encompasses setting based designs that are best when implemented in schools,
workplaces, market areas, residential areas etc. The practical aspects of health promotion
comprise of various approaches that consider the needs of the population on the whole (Chételat
and et.al., 2018). This consists of dividing the population into four groups, namely:
 Healthy population
 Population with risk factors
 Population with symptoms
 Population with disease
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Considering the practical aspect of health promotion, there is a need to target all the four
population groups with a different intervention. The United Kingdom is characterized by an
ageing population. Nearly, 12 million people in UK are aged 65 years or above. Of them,
approximately, 5.4 million people are of the age of 75 years and above.
There are various risk factors for mental health disorders in the elderly. These are illness, loss
of loved one, chronic pain, physical disability, long term illness, loss of mobility, alcohol or
substance abuse etc. (Delle Fave and et.al., 2018). As per the report by royal college of
psychiatrists, it is estimated that by 2026, ageing will become one of the key reasons for increase
in the number of people suffering from mental disorders. This indicates that there is a large
section of elderly population which is at risk of developing a mental disorder.
It is estimated that of all the elderly people living in the GP clinics, 40 per cent suffer from a
mental health problem. This percentage is higher in the older people in hospitals. Approximately,
50 per cent of older people in general hospitals suffer from a mental condition which further rises
to 60 per cent in care homes (Fundamental Facts About Mental Health, 2016).
BEHAVIOR THEORY
Behavior theories perform an important role in examining the predictors of health
behavior as well as its precursors. Self- efficacy and motivation are the two elements which are
common in the various behavior theories (Walters and et.al., 2017). Health Belief Model can be
discussed in relation to the chosen area of mental health and well- being as follows:
Health Belief Model
Developed by Irwin Rosenstock in 1966, it is considered as one of the most influential
models in health promotion. As per this model, the beliefs of an individual about the various
healthy conditions are responsible for prediction of the health- related behaviors in that
individual. This models proposes the following four key factors which have an influence on the
health behaviors:
 Perceived susceptibility – This indicates the assessment that a person makes about his
risk of developing a condition
 Perceived severity- This encompasses the intensity of seriousness of situation and its
consequences
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 Perceived barriers – these include the factors that facilitate as well as hinder the
adoption of a particular behavior by a person (Girdhar, Srivastava and Sethi, 2020). Perceived costs of adhering to the proposed intervention- These include the costs that
the chosen group perceives if they adhere to the proposed intervention for health
promotion.
According to the health belief model (HBM), the likelihood of a person adopting a
particular behavior depends on two aspects. The first is his own belief in perceiving threat of an
illness. The second is the belief of the person in the effectiveness of a recommended action or
health behavior. Applying this model in the area of mental health and wellbeing concerning
elderly people in the UK, it is important to consider that a particular health related behavior will
be adopted by the elderly people when they have a belief that serious consequences will be posed
by the problem for their daily activities (Tough, Siegrist and Fekete, 2017). Further, they will
also adopt the behavior if they have the belief that the proposed intervention will be effective.
Application of HBM in the area of mental health and well-being would imply that the
clinicians need to play an important role in encouraging the patients of mental disorders to
explore the perceived severity associated with mental disorders. Further, the elderly people with
mental health issues will only follow the recommendations provided to them if they are made to
believe that the likelihood of negative outcomes will be decreased by the proposed intervention.
Further, the model would foster health promotion in the selected area by suggesting adoption of a
flexible approach where the elderly patients of mental disorders could decide if he/ she is willing
for the psychotherapy sessions.
However, it can be critically analyzed that it is not necessary that all the behavior changes
are not made on the basis of rational or conscious choices. Further, HBM does not include any
concepts that contain strategies for changes (Barry and et.al., 2019). Hence, its application to the
chosen area of mental health and well – being cannot be considered as holistic. Moreover, the
model only focuses on individual factors. It does not take into account environmental and socio
economic factors. It can be critically analyzed that the model thus encourages victim blaming.
But, considering mental disorders, socio economic and environmental factors play an equally
important role in determining the health behavior of a person.
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Critical assessment of the impact of attitudes towards health, well-being and health promotion
Attitudes towards health have significant impact on the health promotion in mental health
and well-being of elderly. In the UK, the attitudes of people towards elderly is negative whereby
they are mocked and demonized by the society. Ageing is considered as a crisis whereby the old
people are regarded as a burden on the society (Centre for Ageing better, 2021). This indicates
negative attitude of people towards elderly and their health.
Moreover, in the UK, the elderly people also depict a careless attitude towards mental
health. According to the new data, 6 out of 10 people in the UK aged above 65 years experienced
symptoms of anxiety and depression (Age UK, 2020). However, help was not sought by more
than half of those people as they decided to go on with the disease.
Chronic stress is an outcome of negative attitudes that further leads to hormonal
imbalance in the body. The negative attitude also creates a feeling of helplessness among elderly
which in – turn leads to depression, anxiety and other mental health issues. Also, the chemicals
in the brain which create happiness are depleted due to lack of a positive attitude towards health.
In UK, the attitudes of people towards mental health depicts two distinct pictures.
Stigmatizing attitude of people towards these issues in elderly further discourages the latter
group to seek assistance when there is onset of symptoms of mental disorders. This leads to
development of mental health issues which could otherwise have been prevented if medical
assistance could have been taken at initial stages. But, reports also suggest that there has been a
shift in the attitudes of people towards mental health who have become more supportive towards
the population suffering from these issues (Venters, 2018). Similarly, the attitudes towards
promotion of mental health have also become positive whereby the society has begun taking
initiatives to support elderly people with mental disorders. They also encourage the latter to seek
assistance on the onset of symptoms of mental health issues.
The attitudes towards mental health, well-being and promotion impacts the practice in a
number of ways. For tackling the careless attitudes of elderly people as well as the society, more
robust tactics need to be applied in order to successfully implement the health promotion
intervention (Forsman, and et.al., 2018). Furthermore, negative attitudes also present several
challenges in the smooth implementation of health promotion interventions in the area of mental
health and well-being.
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Population-wide versus targeted health promotion interventions
Population wide interventions for health promotion work to intervene all the level of
practice as they are directed towards the entire population as well as the families of the affected
individuals. In contrast to this, targeted health promotion interventions focus on specific group of
people that are negatively affected by a health issue (Gerino and et.al., 2017). The proposed
intervention is targeted on promotion of mental health and well – being in the elderly people.
STRATEGIC AND ACTION PLAN FOR HEALTH PROMOTION
Objectives
 To detect elderly population at risk of developing mental health issues
 To implement suitable strategies for promoting mental health in elderly population with
mental health issues as well as with symptoms of mental disorders
 To foster overall mental health and wellbeing of the elderly population through use of
psychosocial interventions
Interventions
The following Psychosocial interventions will be chosen for promoting the mental health and
wellbeing of elderly population:
 Group support- This intervention comprises of providing social support to the elderly
through various groups.
 Reminiscence- This will comprise of reviewing and recalling past events by the elderly
people.
 Social activities – this will comprise of different types of social activities which will
provide the elderly people with an opportunity to engage with others and play active
roles.
Key considerations
Following will be the key considerations of the strategic plan for promotion of mental health and
well – being in the elderly population in UK:
 Participation: There will be involvement of the families, community as well as
government sectors for preparation and implementation of strategies for promoting metal
health
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 Feasibility: The proposed combination of psychosocial intervention is feasible
considering the given population.
 Innovation: New approaches will be used for implementing the interventions and
bringing them to action.
Anticipated outcomes
Inclusion of elderly people and their active participation in various activities will lead to
enhanced mental health and well – being. Moreover, there will be creation of shared ownership
and responsibility as family, social groups and communities will also be involved in working
towards mental health and well – being of elderly people.
Operational strategies
Determining priorities
The priority areas in mental health and well-being for elderly people in UK include
eradicating loneliness and social isolation. The propose health intervention focuses on the same.
Implementation
Implementation of the plan will comprise of execution of the proposed interventions through the
following strategies:
 Community development programs- These will target the elderly population that suffers
from chronic mental and physical illnesses. Secondly, there will be programs that target
prevention of elder abuse.
 Social programs- Various social and health programs will be designed that aim at those
sections of elderly population that live in remote and rural areas.
Impact of inequalities on health promotion planning and practice
In UK, the elderly population may depict inequalities. This includes the conditions in
which people grow and live. It is characterized by unequal distribution of aspects such as
education, housing and employment. In elderly people suffering from or at risk of mental health
issues, social inequalities may also comprise of social isolation, homelessness and poverty.
Inequalities significantly impact health promotion as well as its planning. This is because
the intervention and specific strategies need to aim at not only the health issue but also at
eradicating the existing inequalities (Andrews and et.al., 2019). This is important as with unequal
health conditions, the outcomes of the interventions could not be achieved. Various stages of the
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health promotion such as planning, faming objectives, designing interventions and specific
strategies and their successful implementation; have to take into account the existing health
inequalities.
Health promotion practice is impacted by inequalities as the social workers and health
care personnel have to ensure that all the people get equal opportunities to benefit from the
health promotion intervention. Thus, specific arrangements will have to be done for those elderly
people who are poverty stricken or live in remote areas to enable them to take part in the social
activities and other interventions.
Ethical and political issues in relation to health promotion
Ethical issues in relation to health promotion include concerns related to infringing on
privacy. Efficacy based considerations include issues related to cost effectiveness of the health
promotion strategies. The strategies used for health promotion need to be cost effective for
achieving the desired outcomes. Further, there are autonomy based concerns which include
issues related to the interference of the health promotion strategies with free choice of people.
People’s right to freedom of choice as well as autonomy is interfered by promotion which raises
ethical issues. Moreover, if the provision of services, as a part of the intervention strategies, is
unequal; it further raises ethical concerns. This indicates the inability regarding provision of fair
opportunities for attaining health goals.
Further, ethical issues may also arise if the health promoters do not respect confidentiality
of the people. Inability to take accountability for judgements and actions may also lead to ethical
concerns. Informed consent is an important aspect that need to be taken into account during
health promotion (Guttman, 2017). As the health promotion strategies are aimed at population on
the whole, the aspect of obtaining informed consent tends to be neglected. However, the same
can raise ethical concerns. Political issues in health promotion may be related to intervention by
government and its various agencies. Further, interference of political interests with the
objectives of health promotion may also be an issue.
Tools for Assessing Community Health Needs
The health needs and priorities of community can be clearly understood by systematically
conducting the community health needs assessment (CHNA) with active participation of
patients, their families, community organizations and their members (McDaid and et.al., 2017).
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There are various tools that can be utilized for assessment of community health needs.
Community health assessment surveys is one such tool. For conducting needs assessment in
mental health, a survey can be distributed among the patients, their families and other
community members. Through this, demographic and health information can be obtained which
helps in planning health promotion for mental disorders. Furthermore, focus group testing is
another tool that can be used for identifying the priority issues of mental health among society.
Further a criteria based scoring system can be used with which the collected data on mental
health can be prioritized and planned into initiatives.
Planning Health Promotion Activities, Using Participatory Methodologies That Engage
Communities
The participatory methodologies that engage communities focus on planning and
implementation of health promotion interventions. The following are the three different types of
community participation approaches:
 The medical approach- This emphasizes health as a state of absence of disease
 The health planning approach- This is based on the view that appropriate and timely
delivery of services leads to the state of health (Brunton and et.al., 2017)
 The community development approach- According to this, health is a result of education
and awareness which encourages the members of the community to take responsibility
and care of their own health
For implementing the chosen combination of psychosocial interventions, community
development approach would be the most suitable. This is justified as it would assist in making
the attitudes of community positive towards old people and mental health and well-being.
Further, it would bring a permanent change in raising awareness and promoting mental health as
it would encourage the community members to be responsible for their health.
Models of community organization and development and their application to health promotion
practice
Three models of community organization have been developed by Rothman. They are the
following:
Locality development model
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According to this model, change can be effected only if there is involvement of a wide
range of people in the community. This involvement should be at various stages such as
planning, implementation and evaluation (Srivarathan and et.al., 2020). This encompasses the
use of democratic procedures and development of local leadership. While this method provides a
number of possible solutions and pathways to tackle a health promotion intervention, the
democratic nature causes delays. Hence with this, there may be a challenges of meeting the
health promotion outcomes of time.
Social planning model
This model entails a process of solving problems in a way which is deliberately planned
as well as technical. However, it can critically analysed that in this method, there is variation in
the degree of participation of community. Hence, using this model for mental health promotion
in elderly may not result in the expected outcomes. This is because, promotion in chosen area
requires participation of community, its members and families as well.
Social action model
This model assumes that in order to make change on the larger community, there is need
to organize the disadvantaged segment of the population. Social justice, redistribution of power
and resources form the key themes of this model (Antoine-LaVigne and et.al., 2018). Using this
model for promotion of mental health and wellbeing in the elderly would require focusing on
those old people who are poverty stricken, abandoned by the families, live in remote areas.
Examining The Pitfalls of Participatory Processes
Participatory approach, when implemented in the promotion of mental health and
wellbeing may suffer from various pitfalls. Firstly, participator approaches consume longer time
and causes delays in reaching to conclusions (Liljas and et.al., 2017). Secondly, health promotion
may face limitations if there is disagreement between the target population and the community
members. Thirdly, the members of the target population and other community members may
need prior knowledge and theory about the mental health issue. This would take further time.
CONCLUSION
From the above report it can be concluded that with the increasing ageing population,
promotion of mental health and wellbeing is a crucial aspect. Ageing is predicted to be one of the
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key reasons for increasing mental disorders in UK. The report designs a planning framework for
health promotion in the area of mental health and well-being in elderly. A combination of three
psychosocial interventions has been designed as the health promotion intervention. This includes
group support, reminiscence and social activities. Implementation of the intervention will be
done thorough community development programs and social programs. Community
development approach is a suitable participatory methodology that can be adopted for engaging
the community in the health promotion of mental health and well-being in elderly.
REFERENCES
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Barry, M.M. and et.al., 2019. Implementing mental health promotion. Springer Nature.
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Gerino, E. and et.al., 2017. Loneliness, resilience, mental health, and quality of life in old age: A
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Girdhar, R., Srivastava, V. and Sethi, S., 2020. Managing mental health issues among elderly
during COVID-19 pandemic. Journal of geriatric care and research. 7(1). pp.32-5.
Liljas, A. E. and et.al., 2017. Strategies to improve engagement of ‘hard to reach’older people in
research on health promotion: a systematic review. BMC public health. 17(1). pp.1-12.
McDaid, D. and et.al., 2017. Commissioning cost-effective services for promotion of mental
health and wellbeing and prevention of mental ill-health.
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Srivarathan, A. and et.al., 2020. Social Relations, Community Engagement and Potentials: A
Qualitative Study Exploring Resident Engagement in a Community-Based Health
Promotion Intervention in a Deprived Social Housing Area. International journal of
environmental research and public health. 17(7). p.2341.
Tough, H., Siegrist, J. and Fekete, C., 2017. Social relationships, mental health and wellbeing in
physical disability: a systematic review. BMC public health. 17(1). pp.1-18.
Walters, K. et.al., 2017. Promoting independence, health and well-being for older people: a
feasibility study of computer-aided health and social risk appraisal system in primary
care. BMC family practice. 18(1). pp.1-10.
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