The report found age discrimination in mental health services
Older people are often denied access to the full range of mental health services available to younger adults, a watchdog has found.
At four out of six mental health trusts examined in England decisions were based as much on age as clinical need, the Healthcare Commission found.
Out-of-hours, alcohol and crisis services, and psychological therapies were often unavailable to the over 65s.
A body representing trusts said new policies would benefit older patients.
Healthcare Commission chief executive Anna Walker called the findings "unacceptable".
The research showed that older people were often prevented from accessing care because of stretched services or a lack of age-appropriate care.
Some staff said patient groups considered to be of high risk to the public or where government targets were applicable were often prioritised, leaving older people's services lagging behind with little funding.
Ms Walker said: "Trusts are not always providing appropriate mental health services to the over 65s.
"It is truly unacceptable that out of hours and crisis services were often not available to older people.
"There needs to be a fundamental shift towards providing care based on a person's clinical need rather than their age.
"Considering a quarter of admissions to mental health inpatient services are over 65, this issue needs urgent attention."
Kate Jopling of Help the Aged said: "It's shocking to think that, despite the need, older people are routinely being denied treatment for mental health services.
"The date on a birth certificate should not be the measure of whether or not someone receives the help they need for a mental health problem."
And Gordon Lishman of Age Concern said the services that did exist for older people were often chronically under funded and are not of the same quality to those offered to adults of working age.
He said the situation was scandalous and urged the government to use laws to stamp out age discrimination.
Care Services Minister Phil Hope said any unfair discrimination against older people was unacceptable.
"We are taking action and we expect NHS trusts to make improvements."
Steve Shrubb, director of the mental health network which represents the majority of mental health trusts said: "We have some of the best mental health services in Europe yet it is clear that there are still improvements to be made to mental health services especially to ensure that older people get access to the correct care when they need it."
He said new policies, such as quality accounts, would put the needs of patients into sharper focus.
Meanwhile, a second study from the Commission of all 68 NHS specialist community mental health trusts in England, found that almost half of under 65s needing specialist mental healthcare still do not have an out-of-hours number if they are in a crisis.
Half of people with schizophrenia have not been offered recommended psychological therapies, it suggested.