Issues in the Development of Community Mental Health Services for Older People in Australia, 1950–2020

Abstract:Early initiatives in the 1950s towards community mental health care for older people focussed on dementia care with trans-institutionalisation from state-funded mental hospitals to mainly Commonwealth-funded nursing homes. Initial efforts led by Herbert Bower at Willsmere Hospital in the 1960s focussed on diagnostic assessments and day hospitals. Comprehensive outreach services for older people from mental hospitals appeared in Victoria and NSW in the late 1960s but remained sporadic until the 1990s. The Aged Care Reform strategy of the 1980s resulted in the acceptance that dementia care was largely a Commonwealth responsibility, consolidating the split from mental health. In contrast, the development of state-funded community older people’s mental health services has varied between the states and territories with Victoria leading the way in the 1990s. Gaps in service development emerged in the 2000s accentuated by the focus of successive National Mental Health Plans on younger people.