Redefining old age psychiatry--pragmatic approach.

The age cut-off of 65 years has long been an arbitrary and illogical criterion for accessing older adult mental health services, and the introduction of the Equality Act (2010) in England andWales (http://www.homeoffice. gov.uk/equalities/equality-act) has probably made it unlawful. However, the ongoing absence of a robust definition of ‘Old Age Psychiatry’ is leading to a fragmentation of services with health providers creating generic all-age services, which we feel is unconscionable. Such ‘ageless’ services will be ill-equipped to meet the complex physical, social and psychological needs of older patients, who often require home-based support. The Age Equality Act does not prohibit age appropriate services, but unless those services are defined, ideally using nationally accepted criteria, the discipline will wither (Anderson, 2011). A broad consultation of stakeholders and service users in Central North West London NHS Foundation Trust on redefining criteria for access to Old Age Psychiatry services focused on the specific skills of clinicians in these services. The resulting criteria were