No, actually not OK

Above: Minister for Mental Health and Ageing, Mark Butler, formally launching the new Research to Practice Briefing 7 

By Keryn Curtis

Helping carers, community aged care workers and family members to recognise the signs of mental illness in elderly people is at the heart of the Benevolent Society’s ‘Research to Practice Briefing 7′, formally launched in Sydney on Wednesday by Minister for  Mental Health and Ageing, Mark Butler.

The Research to Practice Briefing paper, Supporting older people experiencing mental distress or living with mental illness, has been developed by the National Ageing Research Institute (NARI) at the University of Melbourne, in partnership with The Benevolent Society.  It aims to bring together the latest research and knowledge about mental health issues in older people, in an accessible and practical resource for those working in the community aged care sector. 

Launching the new resource, Minister Butler said more needed to be done to integrate health and aged care services and to get out the message that mental illnesses like depression and anxiety are not a normal part of ageing. He said access for older people to good primary care, including both allied health and GP services was essential but that mental health care was a particular challenge. 

Benevolent Society’s CEO, Anne Hollonds, said people often miss or misunderstand mental illness in older people because the symptoms may be similar to other illnesses like dementia, they may be mistaken for normal reactions to grief or major life changes, or people may be more focussed on physical illnesses.

“Too often we think that being sad and lonely is just a normal part of getting older – and that’s simply not the case,” said Ms Hollonds.

“Depression and anxiety are not an ordinary part of ageing, they are serious illnesses and a major risk for older people – in fact, older people have a higher risk of suicide than the general population.

“Older people are often faced with major life changes like the loss of a partner or friends, reduced mobility and independence, or moving out of their home, and it’s normal to experience some grief and sadness around these events.  

“While people often need time and space to deal with grief, unresolved grief may trigger something more serious,” Ms Hollonds said.

Minister Butler said some of the statistics referred to in the Briefing were ‘shocking’, including the estimates that 10 to 15 per cent of older people in the community and up to 50 per cent of people in residential aged care, have symptoms of depression. 

“The suicide stats for men over 85 [the highest proportion of suicides of any age group] are deeply shocking,” he said.

Changing perceptions around ageing

Mr Butler said the new resource also reflected changing perceptions about ageing issues.

“Firstly, [there is] the increasing importance of ageing as a central policy driver of health policy but also of general social services policy.  This is very much a product of numbers and the ageing stats are very well known in this room,” said Mr Butler.

“But we’ve also seen a much higher sensitivity to ageing issues.  We are slowly leaving behind the idea that ageing Australians are a mono-cultural group with a limited range of needs, largely related to their physical health.”

He that increasingly, we understand that older Australians reflect the rest of Australia in their diversity – cultural, gender, sexual and linguistic – and that responses need to reflect that diversity.  

“This practice note really does bring those things to the fore.  Health needs are much more than physical health, like mobility and cardiovascular disease, for example.  It’s not a normal part of ageing to be unhappy. It’s not normal to lose your memory.   Depression and anxiety are not a normal part of ageing that we should ignore. It’s easy to say that but it’s a difficult oil tanker to shift around,” he said. 

Mr Butler said there needed to be a focus on what to do.  “One of the great challenges in health reform and aged care reform is in trying to bring together some of the very good health supports and programs we have.”

Mr Butler pointed to programs for older people with special mental health needs or who have experienced homelessness which he said had been very successful; as well as the recent Teaching and Research Aged Care Services (TRACS) funding as providing new opportunities to bring psychological services and other health care professions into the aged care setting.  

“Often the challenge is the referral pathways to deliver the services in aged care settings.  […] Service pathways are really important. We need to build better connections between the health system – physical health, mental health and aged care.”

The Minister encouraged service providers, health care providers and other stakeholders to come up with innovative ideas to build the connections needed.

“It’s not rocket science.  It can be done,” he said.  

Above:  Author of the Briefing, Dr Briony Dow, presenting her research.

# The Research to Practice Briefing 7: Supporting older people with mental distress or illness reviews the research on the symptoms and treatments of mental illness in older people.  It focuses on how those in the community aged care sector can support people who show signes of mental illness. Funded by The Benevolent Society, it is a free resource for all community aged care providers and is available for download here. Feedback on the briefing is welcome. It was formally launched on Wednesday 26 September in Sydney by Minister for Mental Health and Ageing, Mark Butler. Its primary author is Dr Briony Dow, from NARI, who also presented key research findings at the event and was part of a panel discussion and presentation of case studies. Other Research to Practice Briefings for community aged care workers in the series are also available free from The Benevolent Society website. Click here for access to the full collection.

Recognising symptoms of mental distress
[From The Benevolent Society]

Symptoms that may indicate mental distress include:
• Lack of interest in activitiesthe person normally enjoys
• Neglecting personal hygiene
• Chronic, delayed or sudden grief
• Nightmares or suicidal thoughts
• Difficulty concentrating
• Sudden weight loss

If you notice any of these symptoms in a friend or loved one, encourage them to speak to their doctor.
You can help an older person reduce their risk of mental distress by:

• visiting or phoning them regularly, and encouraging them to keep in touch with other friends and family
• helping them maintain hobbies and interests, like going on outings or to social activities
• helping them with transport
• encouraging them to keep physically active like walking, gardening or shopping.