More than half of older Australians living in residential aged care experience symptoms of anxiety and depression. However until recently, they were unable to access government-subsidised mental health care that is available to adults living in the community. Rectifying this inequity has been the focus of a suite of policy reforms in recent years.

The Aged Care Royal Commission found that a lack of access to appropriate psychological care in residential aged care has likely contributed to inappropriate and avoidable use of chemical and physical restraint, compounding the negative physical and mental health outcomes experienced by residents with mental illness.

Even before the Royal Commission was established, the Australian Government had recognised and begun to improve access to psychological services for older Australians, particularly those living in residential facilities. The 2018–19 budget included $82.5 million over 4 years for the Improved Access to Psychological Services in Residential Aged Care Facilities initiative (the initiative). Under the initiative, the 31 Primary Health Networks (PHNs) across Australia are collaborating with residential aged care facilities to make mental health care available to residents who are experiencing or are at risk of mental health problems.

AHA was engaged to evaluate the initiative, with the objectives of:

• collecting evidence on the effectiveness, efficiency, and any unintended consequences of PHNs’ different approaches to implementing the initiative
• providing evidence-based recommendations about how the initiative can most effectively and efficiently be delivered and communicated to support aged care residents’ mental health.

To meet these objectives we reviewed PHN documentation, analysed routinely collected service utilisation data held by the department, and consulted with representatives of PHNs, professional bodies in the mental health and aged care sectors, health and mental health professionals involved in the initiative, and staff and residents of participating aged care facilities.

Our final report outlined 9 recommendations designed to capitalise on the initiative’s progress to date, and defined actions within each for the department, PHNs, and psychological service providers.