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Chapter 8 Section I: Ageing and mental health conditions

8.I.1: Introduction

Australia’s demographic is ageing across all population groups, including those with mental health conditions. There is increasing policy recognition of the needs of older people with mental health conditions. However, older people with mental health and coexisting conditions do not always have access to the support and care they need. Action to address this situation is urgent, as pressure on services will grow as the population ages and the number of older people with complex mental health problems increases.

Poor mental health is not a normal part of ageing. However, older people can be vulnerable to mental health conditions. Some people develop mental health conditions as they age, while others grow older with the ongoing experience of a mental health condition that developed earlier in their lives.

Many people have experienced stigma and discrimination that is age related. For people who have struggled with mental health issues across the lifespan, negative societal attitudes can aggravate feelings of exclusion, poor self-esteem, helplessness and fear.

Isolation and depression should not be associated with ageing or normalised as a natural part of the ageing process. Mental illness in older people is often managed with medication alone rather than investigating the potential for psychosocial approaches and holistic care, separately or complemented by appropriate pharmaceutical options.

Many people who have mental health problems have experienced trauma in their lives. Such trauma may have been experienced during childhood often in the form of physical and emotional abuse or neglect, violence or other mistreatment, and sometimes this trauma has continued into adulthood and may have occurred whilst in care in mental health facilities or other institutions. Consequently, entering any institution such as an aged care facility can trigger past experiences and be re-victimising and retraumatising to an older person. In particular, for those people previously institutionalised and traumatised in residential mental health facilities, the fear, horror and resistance to being “placed” once more into residential care must be acknowledged and respected.

8.I.2: Specialist Mental Health Service for Older People (SMHSOP)

In NSW the Mental Health Drug and Alcohol Office developed a plan 2005-2015, intended to guide the development of Specialist Mental Health Services for Older People (SMHSOP) in Area Health Services across NSW, 2005-2015. SMHSOP is a comprehensive mental health service for older persons aged 65 years plus.

This ten year plan guides the staged development of SMHSOP across NSW and aims to:

  • Promote improved access to SMHSOP for older people with mental health problems and or at risk of developing mental health problems
  •  Contribute to improved health and mental health outcomes for older people in NSW

The SMHSOP service delivery model is comprised of comprising five clinical service components which include:

  • SMHSOP community teams
  • SMHSOP acute inpatient services
  • SMHSOP non-acute inpatient services
  • SMHSOP community residential services
  • Severely and persistently challenging behaviours model.

SMHSOP includes specialist old age psychiatrists, psycho-geriatric nurses and allied health professionals such as psychologists, occupational therapists and social workers with expertise in mental health problems affecting older people. The service model includes multidisciplinary community or ambulatory teams, designated acute and non-acute inpatient facilities and long-stay community residential facilities.

To read more about the SMHSOP ten year service plan, click here.

8.I.3: My Aged Care

The My Aged Care website has been established by the Australian Government to help you navigate the aged care system. The Gateway is part of the Australian Government’s changes to the aged care system which have been designed to give people more choice, more control and easier access to a full range of aged care services.

My Aged Care is made up of this website and a national contact centre. Together they can provide you with information on aged care, whether for yourself, a family member, friend or someone you’re caring for.

The contact centre can be phoned on 1800 200 422 between 8.00am and 8.00pm on weekdays and between 10.00am and 2.00pm on Saturdays. The My Aged Care phone line is closed on Sundays and national public holidays.

You can expect our staff to provide:

  • prompt, reliable and confidential services
  • clear information, which can be made available:
    • in other languages if you speak another language
    • in other formats if you have hearing difficulties or a vision impairment
  • help to find Government-funded aged care services
  • prompt resolution of any complaint or concern you have with My Aged Care.

If you need an Interpreter

If you speak a language other than English you can phone the Translating and Interpreting Services (TIS) on 131 450. TIS covers more than 100 languages and is available 24 hours a day, 7 days a week, for the cost of a local call.

Alternatively, you can call the National Contact Centre on 1800 200 422 (between 8am and 8pm on weekdays or 10am and 2pm on Saturdays), and we will organise an interpreter through TIS to support the contact centre in communicating with you.

If you have a hearing or speech impairment?

People who are deaf or who have a hearing or speech impairment can contact My Aged Care through the National Relay Service in two easy steps:

8.I.4: SANE

SANE have released a guide to planning ahead for older people who live with mental health conditions, family and friends. This resource is available from their website.

Mental health Information and support
SANE Helpline – For information, advice and referral.
Freecall 1800 18 SANE (7263) Mon–Fri, 9 am–5 pm

8.I.5: Eligibility of older people for mental health services

Older people with mental health conditions are eligible for mental health services on the same basis as other people, whether these are provided by the public sector, the private sector (including through General Practitioner referrals) or the non-government sector.

Refusing to an older person with access to a service they require, because of their age, is likely to constitute unlawful age discrimination under NSW and Commonwealth law. Of course, it would not be unlawful discrimination for an older person with a mental health condition to be refused access to a mental health service designed for a specific population group, such as young people. Similarly, there are some services and programs that are specifically designed for older people with mental health conditions, and the fact that there are age criteria for access to these services would be unlikely to constitute age discrimination.

For more information about what to do if you, or someone you know with a mental health condition experiences age discrimination go to Chapter 7, Section B: The Right to Equality by following this link.

8.I.6: Age Discrimination and people with mental health conditions

Older people with mental health conditions may experience discrimination on the basis of their age or disability, or both. Such discrimination is unlawful in certain areas of life, including in relation to access to goods, services and facilities, employment, education, and clubs and associations.

For more information about age and disability discrimination, including what to do if you or someone you know with mental illness experiences discrimination go to Chapter 7, Section B: The Right to Equality by following this link.

8.I.7: Access to community services for older people with mental health conditions

Generally speaking, the disability and age care systems are separate and distinct service systems and each has its own eligibility criteria.

The National Disability Insurance Scheme (NDIS) is currently in a launch phase and specific age criteria apply in some launch sites until transition to the full scheme commences on 1 July 2016.

In the Hunter launch site, and from 1 July 2016 elsewhere in NSW, the NDIS will be available to otherwise eligible people with disability under the age of 65 years. This means that if you acquire a disability after the age of 65 you are not eligible for the NDIS and must obtain the supports you require from the age care system.

If you acquired your disability prior to the age of 65 (or were born with a disability), and are otherwise eligible, you are entitled to receive support from the NDIS.

People with disability who are existing recipients of disability services from the NDIS (or existing recipients of State and Territory disability support systems that are to be transferred to the NDIS) who turn 65 will continue to be eligible for disability-related support services through the NDIS, but will be expected to obtain supplementary age related supports from the aged care system, and may ultimately be required to transfer to the aged care system.

Aboriginal and Torres Strait Islanders with disability become eligible for aged related services at an earlier age than others. For example, Aboriginal and Torres Strait Islanders become eligible for age related Home Care Services at the age of 45 years, and the planning benchmark for Aboriginal and Torres Strait Islanders for Commonwealth age care assessment is 50 years rather than 70 years for the general population.

For more information about aged care services go to the ‘My Aged Care’ website.

Updated January 30, 2015