A study of six local services by the U.K.'s Healthcare Commission has found ageism in mental-health services with a lack of appropriate provision for people over 65 and limited national information on the quality of specialist services for older people. The Commission found that out-of-hours and crisis services did not take referrals for people over 65, or with dementia. Older people had difficulty using substance-abuse services with much of the provision being aimed at younger men in environments that made them feel uncomfortable. The provision of psychological therapies was also poor in most of the services. In one, out of 1,300 referrals, only 49 were for people over 65.