Mental health in aged care

Mental health is a core component of overall health and wellbeing, enabling people to cope with stress, achieve to their abilities, and contribute to their community. Mental health problems occur on a spectrum that includes mental distress, mental health conditions, and suicidal ideation and behaviour (World Health Organisation 2021).

Mental distress and mental health conditions are common in late life (Dijk and Mierau 2023). The 2020–2022 National Study of Mental Health and Wellbeing identified that 7.9% and 11.1% of men and women, respectively, aged 65 years and older have experienced a mental health condition in the past 12 months (not including dementias) (ABS 2020–2022). Dementia is not considered a mental health condition for the purposes of this report.

Older adults with a mental health condition are more likely to experience disability and reduced health-related quality of life (Porensky et al. 2009). In addition, men aged 85 years and older record the highest age-specific suicide rate of any group (Australian Institute of Health and Welfare 2024).

Mental health in aged care service users

The Australian aged care system offers a range of services to meet the needs of older adults. Services range from supports to remain living independently at home through to full-time care in a residential setting.

There are 3 main types of services in the Australian aged care system:

• Home support (Commonwealth Home Support Programme), which provides entry-level services focused on supporting individuals to undertake tasks of daily living to enable them to be more independent at home and in the community.
• Home care (Home Care Packages Program), which is a more structured, more comprehensive package of home-based support, provided over 4 levels ranging from basic care (Level 1) to more intensive care (Level 4).
• Residential aged care, which provides support and accommodation for people who have been assessed as needing higher levels of care than can be provided in the home, and the option for 24-hour nursing care. Residential care is provided on either a permanent, or a temporary (respite) basis.

There are also several types of flexible care and services for specific population groups available that extend across the spectrum from home support to residential aged care. For more information on aged care services in Australia see the Report on the operation of the Aged Care Act, or visit the Department of Health and Aged Care website.

Older individuals accessing aged care services may be susceptible to poorer mental health because of the health and functioning limitations that lead them to access these services. In addition, approximately half of older adults using residential aged care services have dementia (Harrison et al. 2020), and many experience loneliness (Ogrin et al. 2021).

These changes in circumstances, health conditions and other factors increase older individual’s risk for poor mental health (Dijk and Mierau 2023). Understanding mental wellbeing, the presence of mental health conditions, and incidence of self-injury in aged care service users is important to establish needs and plan for policy and service delivery.

This web report provides a snapshot of what data is available about mental health in aged care. It describes what is known about mental health needs at the time of assessment for aged care services (that is, prior to receiving care) and of deaths due to suicide while accessing aged care.

Full details of the methods used for this analysis can be found in the Technical notes.