title: Mental health service delivery to older people in New South Wales: perceptions of aged care, adult mental health and mental health services for older people.
abstract: OBJECTIVE
  To compare the perceptions of aged care services, adult mental health services and mental health services for older people regarding aspects of mental health service delivery for older people in New South Wales, Australia.
  
  
  METHODS
  The NSW Branch of the Faculty of Psychiatry of Old Age in association with the NSW Centre for Mental Health, sent a postal survey to all aged care services, adult mental health services and mental health services for older people in NSW. The survey canvassed issues ranging across service profiles, regional variations, availability of resources, processes of care, views on working relationships between services, difficulties and gaps experienced, and ways to improve co-ordination and service delivery. Clinical issues such as the management and practice of psychiatric disorders of old age, educational/training requirements and skill and experience in working with older people were explored.
  
  
  RESULTS
  An overall response rate of 86% was achieved, including 95% from aged care services (n = 58), 74% from adult mental health services (n = 62) and 90% from mental health services for older people (n = 20). Only 59% of aged care services and adult mental health services considered that their local mental health services for older people provided an adequate service; resource and budget limitations were portrayed as the main constraint. Mental health services for older people varied widely in structure, settings and activities undertaken. Access to mental health beds for older people was also variable, and alongside staffing levels was considered problematic. Lack of staff training and/or inexperience in psychogeriatrics posed a challenge for aged care services and adult mental health services.
  
  
  CONCLUSIONS
  Relationships between aged care services, adult mental health services and mental health services for older people are affected by lack of access to psychogeriatric staff, resource limitations of mental health services for older people, and inadequate liaison and support between the service types. Joint case conferences, education, increased funding of mental health services for older people, and cross referrals were considered ways to address these issues.
authors.affiliation: School of Psychiatry, Universityof New South Wales, Sydney, Australia. b.draper@unsw.edu.au
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.forename: Tanya
authors.initials: T
authors.lastname: Jochelson
authors.forename: David
authors.initials: D
authors.lastname: Kitching
authors.forename: John
authors.initials: J
authors.lastname: Snowdon
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Bob
authors.initials: B
authors.lastname: Russell
mesh_terms: D000368:Aged; D002391:Catchment Area, Health; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D005852:Geriatric Psychiatry / Q000592:standards*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009517:New South Wales; D011795:Surveys and Questionnaires