OBJECTIVES: Despite the prevalence of mental health problems in later life, older people
markedly underutilise mental health services. A greater awareness of factors influencing older
peoples' attitudes to mental illness may therefore improve recognition, presentation, and
treatment of mental disorders in this population, and so enhance quality of life. This study
explores older people's attitudes to mental illness within the context of ageing, and considers
whether attitudes act as potential barriers to engagement in health-related behaviours, and lead to
lower subjective well-being.
DESIGN/METHOD: A combined qualitative and quantitative methodology was used. First, focus
groups were undertaken to pilot the study questionnaire and explore the subject area. A crosssectional
independent groups design was then employed to compare responses of clinical (i.e.
current service users) and non-clinical participants on a self-report questionnaire assessing
attitudes to mental illness and ageing. 74 completed questionnaires were received (24 clinical; 50
RESULTS: Similar to younger people, older people endorsed a range of positive and negative
attitudes to mental illness. However, when attitudes to mental illness were considered within the
context of ageing and experience a more complex pattern of results emerged. While negative
attitudes to mental illness were associated with negative attitudes to ageing across the entire
sample, clinical participants (and those with prior experience of mental illness) reported more
positive attitudes to mental illness and more negative attitudes to ageing than non-clinical
participants, for whom the reverse was true. Attitudes were also differentially related to
outcomes. Thus, positive attitudes to ageing predicted stronger endorsement of health-related
behaviours (F₍₂,₇₁₎ = 9.93, p < 0.001), while negative attitudes to ageing and mental illness
predicted lower subjective well-being (F₍₄,₆₇₎ = 22.99, p < 0.001)
CONCLUSIONS: Attitudes to mental illness and ageing may be linked and mediated by personal
experience and capacity for psychological self-regulation in the face of age-associated adversity.
As one potential cause of the under-use of mental health services by older people, attitudes to
mental illness in later life should form the focus of targeted health education interventions
designed to address ageist misconceptions and ensure that all older people are given the
opportunity to receive care likely to improve their health and well-being.