Summary

Mental distress and mental health conditions (for example, depression, anxiety) are common in late life (Dijk and Mierau 2023).

Older individuals (that is, non-Indigenous people aged 65 years and older and Aboriginal and/or Torres Strait Islander (First Nations) people aged 50 years and over) accessing aged care services may be susceptible to mental illbeing because of the health and function limitations that lead them to access these services, in combination with high rates of loneliness and bereavement (Ogrin et al. 2021).

This analysis uses available data from aged care assessments and other existing data sources to describe the mental health of people using aged care services in Australia, including incidence of suicide in this population.

Included in this report are people using home care packages and people using permanent residential aged care. Home care packages offer comprehensive home-based support including personal care, social support and other supports to promote independence. On 30 June 2022, around 216,000 people were receiving a home care package.

Permanent residential aged care provides support and accommodation for people who have been assessed as needing higher levels of care than can be provided in the home, including 24-hour nursing care. On 30 June 2022, approximately 181,000 people were living in permanent residential aged care.

Key findings

Between 1 July 2017 and 30 June 2022, the key findings were as follows:

  • When first receiving a home care package, on average 23.1% of all people aged 65 years and over and 31.1% of Aboriginal and Torres Strait Islander (First Nations) people aged 50 years and over were recorded with a mental health condition on their aged care eligibility assessment.
  • At entry to permanent residential aged care, on average 57.7% of all people aged 65 years and over and 58.6% of First Nations people aged 50 years and over were recorded with a mental health condition on their aged care eligibility assessment or their residential aged care funding assessment.
  • These proportions are 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 (9.6% of people 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.
  • Mental health conditions were less commonly recorded in aged care assessments with increasing age. Across all age groups, mental health conditions were more commonly recorded among those living alone.
  • For people aged 65 years and over that entered residential aged care, a Cornell Scale for Depression tool estimated that 62.5% had at least mild symptoms of depression. About 16% were recorded with major symptoms of depression.
  • The average yearly age-standardised suicide rate among people aged 65 years and over receiving a home care package was 21.5 deaths per 100,000 users, and among those living in permanent residential aged care was 13.0 deaths per 100,000 users. This compares to an average yearly rate of 12.9 deaths per 100,000 people in Australia aged 65 years and over.
  • Most aged care users who died by suicide were men and suicide deaths became less common with older age.

These data demonstrate that people accessing aged care services commonly experience poor mental health. However, there are important limitations of the available data sources, including that recording of mental health conditions usually occurs only at the time of assessment before receiving care. While some people are re-assessed later, for most people this means that we don’t know about their mental health needs after their assessments and during their time using care. Collectively, these limitations highlight opportunities to improve data collection and reporting on the mental health and other health care needs of aged care users.

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