Government-Subsidised Mental Health Services Underutilised in Australian Aged Care: Study

Elderly woman in aged care facility. (Pixel-Shot/Adobe Stock)

Less than three percent of Australians with mental health conditions living in residential aged care facilities access government-subsidised mental health services, an analysis by South Australian researchers has found.

The lead author of the study and psychology registrar and epidemiologist from Flinders University, Dr. Monica Cations, said aged care residents are four times more likely to suffer from depression and nine times more likely to have anxiety disorders than the general population of elderly Australians.

“Despite this, less than three percent of residents with a mental health condition in our cohort accessed funding subsidies for mental health services provided by GPs, psychiatrists, or allied health professionals, in contrast to almost 10 percent of the general population,” she said in a Flinders University release on Wednesday.

Analysing data from the Registry of Senior Australians on all non-indigenous people with mental health conditions living in almost three thousand aged care facilities between 2012 and 2017, the study found there were only minimal increases in access across different categories over the period, with only 2.4 percent accessing primary mental health care services in 2016-17 and just 2.3 percent accessing psychiatry services.

Cations said people who have dementia were less likely than those without the condition to access any of the services other than psychiatry ones.

“The under-identification and lack of non-pharmacological treatment of mental illness among people with dementia is a long-documented problem, partly explained by a widespread misbelief that people with dementia cannot benefit from non-pharmacological therapies,” she said.

The Need for Equitable Access to Mental Health Services

The study’s authors acknowledge that residents at the aged care facilities may have received mental health care services not captured by the team’s dataset but stress that those living in residential aged care should have equitable access to public services.

“Mental health care is a pillar of the publicly-funded health care system in Australia, and the low use of publicly-funded services among those living in residential aged care is indicative of major barriers to service access and uptake,” Cations said.

She went on to say that many of these barriers were raised in submissions to the Royal Commission into Aged Care Quality and Safety and include lack of expertise among the workforce, complex eligibility requirements, transport costs, and low priority given to cases in which care was not likely to be disrupted or that were not distressing for residents and staff.

Based on the recommendations of the Royal Commission’s final report and considering how best to implement them, the authors of the study recommend permanently broadening eligibility criteria for Medicare access, upskilling existing staff, embedding mental health workers into aged care services, clearer referral pathways, and vigilant monitoring of programs to ensure quality and adequate investment.

“Our study indicates a need for significant and sustained organisational, policy and funding changes to improve access to mental health care for aged care residents,” Cations said.

Titled “Government-subsidised mental health services are underused in Australian residential aged care facilities”, the study has been accepted for publication in the journal “Australian Health Review”.