This thesis explores experiences of mental health problems among older adults. The systematic review identified public stigma towards mental health problems among older adults and in the limited research on older adults with mental health problems, self-stigma, with rates varying across studies. Stigma was associated with sociodemographic factors such as racial and/or ethnic background and gender and other factors such as help-seeking behaviour and mental health symptoms. A wide variety of mental health stigma measures were used across the studies and there is a need for more consistency in the use of measures to support more meaningful comparisons across studies.

The empirical study explored the experiences of caregiving within 5 couples (n=10) when one partner experienced significant mental health problems for the first time in later life using Interpretative Phenomenological Analysis. Analysis revealed 7 themes: Continuity and Change, Caring: New or Extended Roles, Together and Alone, Not that Sort of Person, Preserving Identities, Needing Them Now, No Roadmap. Central to participants experiences was the importance of relationships where ‘caregiving’ could be seen to affect this or be an extension of relationships. Mental health stigma impacted self and couple identities which related to preservation strategies such as concealment of problems. Recommendations for how mental health services can support caregiving and identities of older couples living with mental health problems are proposed.

The final paper integrates findings from the systematic review and empirical study to discuss implications for clinical practice and future research in more depth. This also includes a personal reflective section to consider the researchers experiences and beliefs through which the interview data was interpreted and seek to make explicit motivations and biases to enable the reader to situate and interpret research findings.