Introduction

By way of situating the book's broader discourse on mental health in later life, Chapter 1 offers an overview of the UK's socio-demographic and policy context. It also offers key data on the prevalence and nature of primary mental health problems associated with later life and discussion of those issues that are situated on its boundary, such as loneliness and social exclusion.

First, a word about terminology. The term ‘later life’ will be used throughout the book in preference to the more commonly used terms ‘old age’ or ‘the elderly’. This is in part to make the link between the reader's current life (assuming some readers will be younger) and their own later life and partly to challenge existing stereotypes and prejudices in relationship to ‘old age’. ‘Old age’ positions people inside an age – however ill-defined – which not only obscures the importance of issues unrelated to age but tends to also obscure the complexity and heterogeneity of a large and varied cohort(s) of people. The fact that someone aged 100 is very likely to have a profoundly different life course, lifestyle, health status, and situation than someone aged 65 is a primary challenge to ‘age related’ evidence. Data around trends in prevalence and incidence of ill health among older people hides important distinctions and encourages a tendency towards simplification and homogenisation (Lloyd, 2012). UK-wide (and European) data may also eclipse country and regional differences. The fact that people in Glasgow die 12 to 14 years earlier than people in a wealthy inner London borough (for example Kensington and Chelsea) is a distinctive example (Moffatt et al, 2012). Another, intra-area, example is that in Stockton-on-Tees (North-East England) the gap in life expectancy between the most and least affluent wards is 17 years for men and 12 years for women (Bambra, 2016).

The World Health Organization (WHO) (2002b) notes that in most (developed) countries a person is considered ‘old’ at 65 years. This simply reflects the age at which many people retire from paid work although this pattern is not as established as it once was (Phillipson, 2013).