Many older adults may present with mental health concerns similar to other age groups, and general mental health assessment and intervention skills will be useful for this population. There are also unique challenges that become more common with age. These can include comorbid physical illnesses, bereavement, cognitive decline or impairment, transition to retirement or to assisted living arrangements, and end of life planning. This practice toolkit contains information and resources to support your practice and develop skills and knowledge for working with older people experiencing mental health concerns.

The following resource is designed for mental health practitioners working in rural or regional NSW who have not completed specific training in working with older adults but may be treatment providers for this population.

This is an introduction to working with older adults and is not exhaustive nor designed as a treatment manual. It is not designed to replace clinical decision making or specific training. We encourage all practitioners who are working with older adults to seek training in evidence-based treatments and engage in professional supervision and reflective practice.

1. Australian Bureau of Statistics. Disability, Ageing and Carers, Australia: Summary of Findings.
https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/2018#older-people; 2019. 

2. Carstensen LL, Turan B, Scheibe S, Ram N, Ersner-Hershfield H, Samanez-Larkin GR, et al. Emotional experience improves with age: Evidence based on over 10 years of experience sampling. Psychology and Aging. 2011;26(1):21–33. 

3. NSW Ministry of Health. Specialist Mental Health Services for Older People (SMHSOP) Community Model of Care Guideline. 2017.

4. Fitzpatrick SJ, Handley T, Powell N, Read D, Inder KJ, Perkins D, et al. Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation. PLoS ONE. 2021;16(7):e0245271. 

5. National Institute for Health and Care Excellence (NICE). Older people: independence and mental wellbeing [Internet]. 2015. Available from:

6. National Institute for Health and Care Excellence (NICE). Mental wellbeing and independence for older people [Internet]. 2016. Available from:

7. Australian Institute of Health and Welfare. Dementia in Australia 2021: Summary report. Canberra: AIHW; 2021. 

8. Shin C, Park MH, Lee SH, Ko YH, Kim YK, Han KM, et al. Usefulness of the 15-item geriatric depression scale (GDS-15) for classifying minor and major depressive disorders among community-dwelling elders. Journal of Affective Disorders. 2019;259:370–5. 

9. Park SH, Cho YS. Predictive validity of the Cornell Scale for depression in dementia among older adults with and without dementia: A systematic review and meta-analysis. Psychiatry Research. 2022;310:114445. 

10. Nielsen TR, Jørgensen K. Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis. Int Psychogeriatr. 2020;32(9):1031–44. 

11. Storey JE, Rowland JTJ, Conforti DA, Dickson HG. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. Int Psychogeriatr. 2004;16(1):13–31. 

12. Lutz J, Van Orden KA. Sadness and Worry in Older Adults. Medical Clinics of North America. 2020;104(5):843–54. 

13. Burroughs H. “Justifiable depression”: how primary care professionals and patients view late-life depression? a qualitative study. Family Practice. 2006;23(3):369–77. 

14. Muir-Cochrane E, O’Kane D, Barkway P, Oster C, Fuller J. Service provision for older people with mental health problems in a rural area of Australia. Aging & Mental Health. 2014;18(6):759–66. 

15. Stewart H, Jameson JP, Curtin L. The relationship between stigma and self-reported willingness to use mental health services among rural and urban older adults. Psychological Services. 2015;12(2):141–8. 

16. Daley S, Newton D, Slade M, Murray J, Banerjee S. Development of a framework for recovery in older people with mental disorder: A framework for recovery in older people with mental disorder. Int J Geriatr Psychiatry. 2013;28(5):522–9. 

17. Suicide Prevention Australia. Older People Policy Position. 2022. 

18. Australian Institute of Health and Welfare. Deaths by suicide by remoteness areas [Internet]. 2022. Available from:

19. Conwell Y, Lutz J. Lifespan development and suicide in later life. Int Psychogeriatr. 2021;33(2):117–9. 

20. Hafford-Letchfield T, Jain B, Gleeson H, Roesch C, Ellmers T. A scoping review exploring the ‘grey area’ of suicide-related expression in later life: Developing a conceptual framework for professional engagement. Ageing and Society. 2022:13;1–30. 

21. Rose N, Whitworth A, Smart S, Oliver E, Cartwright J. “I remember when … ”: The impact of reminiscence therapy on discourse production in older adults with cognitive impairment. International Journal of Speech-Language Pathology. 2020:22(3):359–71. 

22. Woods B, O’Philbin L, Farrell EM, Spector AE, Orrell M. Reminiscence therapy for dementia. Cochrane Dementia and Cognitive Improvement Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2018 (3). Available from:

23. Rubin A, Parrish DE, Miyawaki CE. Benchmarks for Evaluating Life Review and Reminiscence Therapy in Alleviating Depression among Older Adults. Social Work. 2019;64(1):61–72. 

24. Cuevas PEG, Davidson PM, Mejilla JL, Rodney TW. Reminiscence therapy for older adults with Alzheimer’s disease: A literature review. Int J Mental Health Nurs. 2020;29(3):364–71. 

25. Justo‐Henriques SI, Pérez‐Sáez E, Alves Apóstolo JL. Multicentre randomised controlled trial about the effect of individual reminiscence therapy in older adults with neurocognitive disorders. Int J Geriatr Psychiatry. 2021;36(5):704–12. 

26. Westerhof GJ, Slatman S. In search of the best evidence for life review therapy to reduce depressive symptoms in older adults: A meta-analysis of randomized controlled trials. Clinical Psychology: Science and Practice. 2019;26(4):11–11. 

27. Serrano JP, Latorre JM, Gatz M, Montanes J. Life Review Therapy Using Autobiographical Retrieval Practice for Older Adults With Depressive Symptomatology. Psychology and Aging. 2004;19(2):272–7. 

28. Orgeta V, Brede J, Livingston G. Behavioural activation for depression in older people: systematic review and meta-analysis. Br J Psychiatry. 2017;211(5):274–9. 

29. Uphoff E, Ekers D, Robertson L, Dawson S, Sanger E, South E, et al. Behavioural activation therapy for depression in adults. Cochrane Common Mental Disorders Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2020; Available from:

30. Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Veronese N, et al. Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias. Rev Bras Psiquiatr. 2016;38(3):247–54. 

31. Bauman A, Merom D, Bull FC, Buchner DM, Fiatarone Singh MA. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote “Active Aging.” Geront. 2016;56(Suppl 2):S268–80. 

32. Gooneratne NS, Vitiello MV. Sleep in Older Adults. Clinics in Geriatric Medicine. 2014;30(3):591–627. 

33. Krause-Parello CA, Gulick EE, Basin B. Loneliness, Depression, and Physical Activity in Older Adults: The Therapeutic Role of Human–Animal Interactions. Anthrozoös. 2019;32(2):239–54. 

34. Hui Gan GZ, Hill AM, Yeung P, Keesing S, Netto JA. Pet ownership and its influence on mental health in older adults. Aging & Mental Health. 2020;24(10):1605–12. 

35. Janevic MR, Shute V, Connell CM, Piette JD, Goesling J, Fynke J. The Role of Pets in Supporting Cognitive-Behavioral Chronic Pain Self-Management: Perspectives of Older Adults. J Appl Gerontol. 2020;39(10):1088–96. 

36. Koh WQ, Ang FXH, Casey D. Impacts of Low-cost Robotic Pets for Older Adults and People With Dementia: Scoping Review. JMIR Rehabil Assist Technol. 2021;8(1):e25340. 

37. Leng M, Liu P, Zhang P, Hu M, Zhou H, Li G, et al. Pet robot intervention for people with dementia: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Research. 2019;271:516–25. 

38. Tavares LR, Vagos P, Xavier A. The role of self-compassion in the psychological (mal)adjustment of older adults: a scoping review. Int Psychogeriatr. 2020;1–14. 

39. Brown L, Huffman JC, Bryant C. Self-compassionate Aging: A Systematic Review. The Gerontologist. 2019;59(4):e311–24. 

40. Kukla H, Herrler A, Strupp J, Voltz R. “My life became more meaningful”: confronting one’s own end of life and its effects on well-being—a qualitative study. BMC Palliat Care. 2022;21(1):58. 

41. Chen H, Cheal K, McDonel Herr EC, Zubritsky C, Levkoff SE. Religious participation as a predictor of mental health status and treatment outcomes in older persons. Int J Geriat Psychiatry. 2007;22(2):144–53. 

42. Tjernberg J, Bökberg C. Older persons’ thoughts about death and dying and their experiences of care in end-of-life: a qualitative study. BMC Nurs. 2020;19(1):123. 

43. Moestrup L. Existential concerns about death — a qualitative study of dying patients in a danish hospice. BMJ Support Palliat Care. 2014;4:A23.1-A23. 

44. Schut MS Henk. The dual process model of coping with bereavement: rationale and description. Death Studies. 1999;23(3):197–224. 

45. Fiore J. A Systematic Review of the Dual Process Model of Coping With Bereavement (1999–2016). Omega (Westport). 2021;84(2):414–58. 

46. Shear MK, Ghesquiere A, Glickman K. Bereavement and Complicated Grief. Curr Psychiatry Rep. 2013;15(11):406. 

47. Roberts KE, Walsh LE, Saracino RM, Fogarty J, Coats T, Goldberg J, et al. A Systematic Review of Treatment Options for Grieving Older Adults. Curr Treat Options Psych. 2019;6(4):422–49. 

48. Fakoya OA, McCorry NK, Donnelly M. Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC Public Health. 2020;20(1):129. 

49. Krzeczkowska A, Spalding DM, McGeown WJ, Gow AJ, Carlson MC, Nicholls LAB. A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes. Ageing Research Reviews. 2021;71:101400. 

50. Murayama Y, Ohba H, Yasunaga M, Nonaka K, Takeuchi R, Nishi M, et al. The effect of intergenerational programs on the mental health of elderly adults. Aging & Mental Health. 2015;19(4):306–14. 

51. Clements-Cortés A, Yip J. Social Prescribing for an Aging Population. Activities, Adaptation & Aging. 2020;44(4):327–40. 

52. Percival A, Newton C, Mulligan K, Petrella RJ, Ashe MC. Systematic review of social prescribing and older adults: where to from here? Fam Med Com Health. 2022:e001829. 

How useful was this post?

Click on a star to rate it!

Average rating 5 / 5. Vote count: 5

No votes so far! Be the first to rate this post.

Feedback - Gravity

Create a Free Account

to see this and many other helpful resources

Welcome! Please log in or create a FREE account to access this page

Create a Free Account

to see this and many other helpful resources