Many older people with mental health problems are being denied treatment because of their age, according to the Healthcare Commission.
It reports that the NHS frequently discriminates against the over-65s on the basis of cost, while others are not even being referred for specialist treatment by their GPs.
It says that mental health problems afflict 40% of those who visit their GP, half of those in hospital and 60% of those in care homes.
Experts who examined six mental health trusts found that only two were treating people on the basis of need rather than age.
Commenting on the issue of referrals by GPs, a commission spokeswoman said: "Often the first step for a person seeking treatment for a mental health problem will be a visit to their GP.
"GPs should make sure they are aware of the specific needs of older people and refer them to appropriate services when necessary."
She added: "All patients should be entitled to access the treatment they need, regardless of age.
"There needs to be a fundamental shift towards providing care based on a person's clinical need rather than their age."
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