Patterns of Service Provision in Older People's Mental Health Care in Australia.

Hossein Tabatabaei-Jafari,Nasser Bagheri,Jose A Salinas-Perez,Peter Mcgeorge,David Burke,John Mendoza,Luis Salvador-Carulla,Mary Anne Furst

doi:10.3390/ijerph17228516

Abstract

Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.

Highlights

A growing proportion of the population is surviving longer and becoming vulnerable to decline in cognition and to mental disorders associated with medical comorbidities [1,2]
The population density of the study areas shows the configuration of urban clusters and remote areas that represent Australia’s unique pattern of population density: a pattern characterised by both high urbanisation and high remoteness [40]
The Social-Economic Indexes for Area (SEIFA), which ranks areas in Australia according to relative socio-economic advantage and disadvantage, is slightly lower in rural areas than the average in Australia, while it is slightly higher in urban areas

Summary

Introduction

A growing proportion of the population is surviving longer and becoming vulnerable to decline in cognition and to mental disorders associated with medical comorbidities [1,2]. The prevalence of cognitive impairment and dementia affects more than 40% of those aged 80 years and over [3]; and mental disorders are the third leading cause (after musculoskeletal disorders and other non-communicable disorders) of the burden of disease for people aged 65 to 74 in Australia [4]. The overall prevalence of depression is estimated to be more than 25% in this population group [5]; with suicide rates steadily increasing with age [6]. Res. Public Health 2020, 17, 8516; doi:10.3390/ijerph17228516 www.mdpi.com/journal/ijerph

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