Australia is a large country with a small but rapidly aging population. Medical services are generally excellent, accessible and affordable due to government subsidies.
For reasons of history, mental health services are run by state governments and therefore vary from one state to another. Victoria, a small highly urbanized state on the southeastern seaboard, leads the way with written guidelines outlining the structure, function and size of child, adult and aged mental health services.
A typical Victorian aged psychiatry service comprises a multi-disciplinary community team, acute inpatient unit and specialist nursing home. My own service in Melbourne’s southern suburbs serves roughly 40,000 people aged 65+ by means of a 14-person community team, 20 acute beds and 45 specialist residential beds. The Victorian government also funds academic psychiatrists, nurse educators, staff training programs and memory clinics. Rural areas receive just as much attention as urban ones.
Some other states have patchy, bed-based aged psychiatry services in capital cities with little if any provision for older people in regional and remote areas. Adult mental health services do the best they can to meet this shortfall. Private psychiatry flourishes but has limited interest in frail, confused people and those in residential care.
The future is still bright. The Faculty of Psychiatry of Old Age, which is a part of the Royal Australian and New Zealand College of Psychiatrists, is now four years old and has advanced trainees in both countries. These are our new specialists. The Faculty is currently benchmarking services to provide data to lobby state governments for a better deal for older people.
On a broader front, nursing homes are now monitored closely by the Federal government to ensure that residents’ mental and emotional needs are addressed and the National Mental Health Plan speaks of the need to provide equitable access to psychiatric services, irrespective of age and geography.
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