Previous chapters will have reported on the growing elderly population and the burgeoning expectations that have accompanied a remarkable period of development in the UK over the last 30 years. They will also have touched upon how mental health services have changed in that time, with increasing focus on care in the community and subsequent de-institutionalisation. Notwithstanding the recent economic downturn, these factors have resulted in one further trend, increasing pressure on public finances to deliver specialist mental health services for older people (MHSOP).