The Talking Mental Health project improved mental health support for older adults in home care through co-designed training, digital tools, and enhanced reporting, increasing staff confidence and client outcomes. It won the Research category in the 2024 Future of Ageing awards. The award was presented at a presentation dinner in Sydney on August 29 – view all of the winners here…
The “Talking Mental Health: Implementing Co-Designed Processes to Improve the Mental Health of Older Adults Receiving Home Care Services” project was a collaboration between Uniting AgeWell, Flinders University, and the National Ageing Research Institute (NARI). It was funded by Aged Care Research and Industry Innovation Australia (ARIIA) and focused on equipping home care workers with the skills and confidence to identify and respond to the mental health needs of older Australians. The project was implemented in Uniting AgeWell’s west metropolitan Melbourne region, involving approximately 2,000 clients and 200 staff.
Why it came about
Uniting AgeWell’s Mental Health and Wellbeing Framework, informed by literature reviews and stakeholder interviews, highlighted a critical gap in mental health support for older people receiving care. The Royal Commission into Aged Care Quality and Safety found that mental health needs in aged care were inadequately addressed, with staff lacking the necessary training to support older adults with mental health conditions.
Older adults in the community often access mental health services through general practitioners and private mental health services, both of which face workforce shortages. Those who do not present with severe mental health risks, such as suicidal intent, often lack access to appropriate mental health care. Furthermore, older adults are less likely to self-report mental health concerns compared to younger individuals.
The project sought to address these challenges by equipping home care workers—who have regular and trusted interactions with older people—with mental health literacy, knowledge of referral pathways, and efficient data collection systems. This initiative aligned with government priorities, research evidence, and Uniting AgeWell’s organisational commitment to mental health.
Implementation and approach
The project received a $160,000 grant from ARIIA, supplemented by $40,000 in cash contributions from Uniting AgeWell, as well as significant in-kind support. Its objectives were structured around four key areas:
- Intake: Enhancing initial assessment processes to better capture mental health information.
- Conversations: Improving staff skills in identifying and discussing mental health concerns.
- Reporting: Establishing systems for frontline staff to record observations effectively.
- Escalations: Creating clear referral pathways for follow-up and intervention.
The project was co-designed with staff, clients, family carers, and experts from Beyond Blue and Mental Health First Aid Australia, ensuring relevance and sustainability. The following outputs were developed:
- Two e-learning modules on mental health for staff (completed by 150 employees).
- Revised intake processes to incorporate improved mental health assessment tools.
- A mobile application for home care workers to log mental health-related observations.
- A structured reporting and escalation process for mental health concerns.
- Two-day face-to-face Mental Health First Aid training for approximately 50 care management staff.
- Referral information sessions to support appropriate mental health service connections.
- In-person training for 186 staff on using new tools and protocols.
The project was piloted from October to December 2023 for 1,900 people, with iterative testing and refinement of tools. A comprehensive evaluation framework, including staff surveys, focus groups, and data analysis, was used to assess outcomes and impact.
Stakeholder engagement
The project engaged a broad range of stakeholders, including:
- Older adults with lived experience and their families.
- Academic researchers specialising in mental health and ageing.
- Mental health organizations such as Beyond Blue and Mental Health First Aid Australia.
- Frontline home care workers and care management staff.
- Uniting AgeWell leadership and strategy teams.
Engagement strategies included co-design workshops, in-person and online training, focus groups, and surveys. Staff received Certificates of Participation, and the project gained visibility through Uniting AgeWell’s communication channels. A celebratory event marked the conclusion of the pilot phase.
Evidence of success
Key measurable outcomes included:
- 148 staff participated in co-design activities, training, and surveys.
- 72% of staff reported increased confidence in discussing mental health with clients.
- 88% of staff reported improved mental health-related skills.
- 69% of staff reported enhanced knowledge of older adults’ mental health needs.
- Quality of life assessments in care plans increased from 9% to 36%.
- 24,000 reports were generated by home care workers using the mobile application.
- 275 instances across 149 clients (5% of total pilot clients) where a mental health issue was identified.
- 17 clients received follow-ups for care plan reviews or referrals.
Sustainability
The success of the pilot has led to plans for expanding these protocols and training programs across Uniting AgeWell’s home care services in Victoria and Tasmania. The co-designed tools and training resources will be embedded into ongoing staff education, ensuring long-term sustainability. Additionally, the project’s findings will inform broader policy discussions on integrating mental health support into aged care services nationwide.
The Talking Mental Health project effectively addressed critical gaps in mental health support for older adults receiving home care services. By equipping home care workers with practical tools, skills, and referral pathways, the project has strengthened the capacity of aged care services to meet the complex mental health needs of older Australians. The initiative demonstrates how co-design and collaboration can lead to meaningful improvements in care quality and accessibility.
