Home' Australian Ageing Agenda : AAA Jan-Feb 2014 Contents appointment in 2010 of Australia's first federal minister for
mental health and ageing, McKay says there were more missed
opportunities than real gains during Butler's term.
"I don't think there was a sense of connection and need to
connect the two portfolios of ageing and mental illness.
"Unfortunately those portfolios have been even further separated
in the new government, which really is cause for significant concern."
McKay says it has been a very difficult task to maintain
policy momentum around the mental health needs of older
people. Tellingly, in 2008, then minister for ageing Justine Elliot
commissioned a report into residential care and people with
psychogeriatric disorders and subsequently set up a 14-member
Psychogeriatric Care Expert Reference Group to devise a
framework for psychogeriatric services. That framework was
never publicly released or developed into government policy.
TACKLING STIGMA AND AGEISM
Jack Heath, CEO of SANE Australia, says older people with
mental illness face the double stigma of ageing and mental illness,
which can also act as a barrier to the treatment and support
when they show symptoms.
He says there is a dangerous misconception that depression
is a natural part of ageing and calls for improved awareness and
training targeting the aged care sector.
"There have been many changes to aged care policy, but there
is still a lack of attention to mental illness in the elderly. If we are
to work towards an inclusive society then we must consider all its
citizens," Heath says.
"We have a lot of work to do in reframing what we think age
is about," says McKay. "It is about ongoing contribution rather
than the sense of being a burden with an inevitable decline and
inability to contribute.
"I think within that context we will have more hope that
mental illness in later life will be seen as something that isn't
normal and can be treated."
*Not his real name. n
ADVOCACY FOR 'SPECIAL NEEDS' STATUS
To improve recognition and support for older people with mental
illness, some groups have pushed for formal recognition within
the Aged Care Act. Special needs status has been supported
by a number of organisations which, along with the NMHC and
RANZCP include the Consumers Health Forum of Australia and
the former Labor government's Psychogeriatric Care Expert
There are currently eight groups with special needs status in
the aged care system, most recently LGBTI people, people who
are homeless or at risk of homelessness and people who were in
institutionalised care as a child.
Professor Allan Fels, chair of the NMHC, says given the
links between mental health and aged care and the alarmingly
high prevalence of mental illness among older people, explicit
recognition is essential.
Dr Rod McKay, who also supports the recommendation,
says unlike services in the community, the aged care system
is currently not accountable under any specific mental health
standards. "Having recognition as a special needs group would
start the process of ensuring that good care of mental illness is
not dependent solely on good leadership within organisations or
residential facilities," he says.
ANY WINS IN LLLB?
As part of the LLLB reforms legislated in June 2013, the
Australian Greens tried to negotiate for the inclusion of a
separate mental health supplement to support the delivery of
care to this group.
While the Greens' advocacy for a homeless supplement
won support, the government rejected a specific mental health
supplement and instead agreed to expand the dementia
supplement to recognise cognitive impairment and severe and
Former minister for mental health and ageing Mark Butler also
agreed to review older people's access to mental health services
in the 2016-2017 review of the reforms.
Senator Rachel Siewert, Australian Greens spokesperson on
ageing, tells AAA that while the expanded dementia supplement
is welcome, it will not address the broader mental health needs of
"It is really clear that there are mental health issues beyond
dementia and I remain concerned that broader mental health
needs may be missed out," she says.
Significantly, the new dementia and severe behaviours
supplement, which came into effect from August 2013, will not
target the large numbers of people in residential aged care with
symptoms of depression due to its focus on challenging behaviours.
According to a recent report by the Australian Institute of
Health and Welfare more than 50 per cent of permanent aged
care residents show signs of depression. This finding was much
higher than previous estimates and five times higher than current
estimates of depression in older people in the community.
Siewert says she is seeking the same commitment from the
new minister responsible for mental health, Peter Dutton, to
review the need for a specific mental health supplement for older
people in 2016.
A COMPREHENSIVE APPROACH
While targeted supplements are an important funding
mechanism, mental health experts acknowledge they form only
part of the picture for effective reform.
Other important drivers include improved training for GPs and
aged care staff, embedding standards for mental health care in aged
care accreditation and increasing collaboration and coordinated
service planning between the mental health and aged care sectors.
McKay says defining the core responsibilities of mental health
and aged care services in the treatment of mental health illness in
older people is a fundamental first step.
He says for too long responsibility for mental health treatment
in aged care has been unclear, which has hampered appropriate
planning and policy direction at a national level.
While there was considerable optimism around the
L-R: Clinical care leader Katherine Groves and residential manager
Sharon Hesse from St Francis Residential Aged Care in Orange, NSW.
www.australianageingagenda.com.au | 39
Links Archive AAA Mar-Apl 2014 AAA May-Jun 2014 Navigation Previous Page Next Page