Mental health in aged care

This analysis demonstrates that many people aged 65 years and over, and many Aboriginal and Torres Strait Islander (First Nations) people aged 50 years and over, accessing Australian aged care services in 2017–2022 were recorded with a mental health condition at the time of their eligibility and/or funding assessment. On average, 23.1% of all people aged 65 years and over that started receiving a home care package and 57.7% of all people aged 65 years and over entering permanent residential aged care were recorded with a mental health condition, respectively.

This proportion is higher than the reported prevalence of mental health conditions in the general population of older adults in the 2022 National Study of Mental Health and Wellbeing (7.9% of men and 11.1% of women aged 65 to 85 years) (ABS 2020–2022). This may reflect a decline in mental health as care needs increase, and/or may in part be attributable to differences in data collection.

In addition, data from the National Death Index indicates that the average yearly age-standardised suicide rate among people aged 65 years and over using home care (22.5/100,000 users) is higher than the average yearly rate in permanent residential aged care (13.0/100,000 users) and in the general population of people in Australia aged 65 years and over (12.9/100,000 people). This may reflect that receiving residential aged care is protective against suicide risk among those requiring care, limits access to means, and/or that the functional impairments that necessitate care limit the ability to engage in lethal self-harm.

Future directions

These data provide an important snapshot of mental health needs at the time of assessment for aged care services and at the time of death. They demonstrate that people accessing aged care services commonly experience mental distress and mental health conditions. However, they do not provide a full picture of the mental health needs of aged care users.

The limitations of the available data sources, described earlier in this report, highlight opportunities to improve data collection and reporting on the mental health needs of aged care users. 

Opportunities for data improvement might include:

• Expansion of current aged care funding assessments (that is, within AN-ACC or future classification tools) to identify mental health conditions and mental health needs, for example similar to items in the prior ACFI tool.
• Efforts to improve uptake of Supplementary Assessment Tools within the National Screening and Assessment Form (and other future tools).
• Ability within the National Screening and Assessment Form to specify whether mental health conditions were diagnosed recently or are long-standing. These data would be helpful to identify those in need of longer-term care and those experiencing a mental health response to their changing life circumstances.
• Implementation of routine monitoring of mental health needs after entry to aged care services.
• Monitoring of uptake of mental health services among aged care users, and comprehensive examination of the impact of stigma and ageism on help seeking among people using aged care services (Temple et al. 2021).
• Inclusion of people living in residential aged care in national prevalence surveys, including the National Study of Mental Health and Wellbeing.
• Improved integration of aged care data sets with health, hospital, and medication data sets so that other aspects of mental health can be examined.
• Comprehensive evaluation of the mental health needs of carers of older adults requiring care, given that these needs can affect those of the person receiving care (Camões-Costa et al. 2024).

Improving the collection, availability, and reporting of data about mental health in aged care users can guide policy planning and service delivery to promote mental wellbeing.