Reports by Fairfax Media earlier this week that people living in residential aged care are being denied subsidised mental health treatment plans because they do not live in the “community” have led to renewed calls for a review of the Better Access Medicare program and integration of the new Health Care Home model with aged care.

In an article published in the Sydney Morning Herald on Monday several health leaders labelled the exclusion of people living in residential care, where the prevalence of depression is known to be higher than in the general community, from accessing subsidised psychology therapies as ‘ridiculous’ and ‘a blatantly discriminatory disgrace’.

The article also claimed that many residential care staff are not adequately trained in understanding mental illness, citing unpublished data from a Swinburne University survey that suggests staff commonly dismiss depressed residents as “attention seeking”.

Two of the aged care peak bodies said the report failed to recognise the positive work being by aged care providers to improve people’s quality of life and that it shows neglect by Government in creating different rules for people living in residential care versus those living in the community.

“The issue of mental illness in an issue for all Australians.  As such, access to appropriate mental health care and services for older Australians also needs to be understood and appropriately catered for,” LASA CEO Sean Rooney said.

“LASA calls for these types of issues to be considered as part of any revision of the funding instrument for aged care.”

“Accessibility concerns are also something that need to be considered as part of the introduction of the Health Care Home model and looking at how services delivered under this initiative integrates with people living in residential aged care,” he said.

While the Fairfax article suggested aged care providers should picking up the bill for residents’ mental health therapies in the absence of Government support, the Aged Care Guild CEO, Cameron O’Reilly, said it is completely unreasonable for anyone to expect ACFI funding to be stretched further than it already is.

“In the rest of the community it’s recognised that mental health requires specialist needs, but the same support and access to specialist services through Medicare is not made available to people living in residential care,” he said.

“The current funding envelope is already stretched to the limit. It could not be expected to cover specialist services, and nor could we expect psychological care to be delivered as a general aged care service through the skills set of our workforce.”

“To say that aged care operators are not attending to the needs of residents is wrong, and does not consider the many initiatives being undertaken to improve quality of life and mental health,” Mr O’Reilly said.

“The build environment is improving and a huge amount is being invested by providers to create the right physical environment for residents. Lifestyle services are being offered and providers make a real effort to facilitate residents’ access to local services,” he said.

According to the Fairfax report, audits by Sydney and Deakin universities have repeatedly found that fewer than two per cent of residents suffering depression have received psychological therapy which is clinically recommended for most people with depression living in residential care.

The report also raised concerns about the overuse of anti-depressants amongst elderly people in place of psychological care, noting the higher risk of falls and fractures as adverse effects.

In an article published on The Conversation, Sunil Bhar, an Associate Professor of Psychology at Swinburne University of Technology, said that more than half of aged care residents have symptoms of depression which often go undetected for a number of reasons.

“People entering aged care have more complex care needs due to physical and cognitive difficulties. They may also have difficulties adjusting to their loss of independence and routine. These factors all increase their risk of depression and suicidal ideation, however, mental illness often remains undetected among aged care residents,” he said.

“There are several reasons for this. People living in residential aged care usually have complex care needs, making the identification of depression difficult, as the emotional symptoms become confused with those of other conditions. Older people are also less likely than younger people to recognise their own symptoms, often attributing them to normal ageing.”

Beyondblue has a range of resources for people working in aged care and care providers to detect and manage depression and anxiety among older people in their care.

These include: