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Specialist Mental Health Services for Older People - Community Residential Care Service Models

What it is

Community residential care or extended care models provide long term care for people with severe and persistent psychiatric symptoms associated with dementia and or mental illness through partnerships between SMHSOP, aged care services/ACATS and the residential aged care sector.

How it works

One model of community residential care for older people with complex and persistent psychiatric symptoms associated with dementia and/or mental illness is the Mental Health Aged Care Partnership Initiative model. This model has been operating in two pilot sites for a number of years, and has been formally evaluated. Further models of community residential care are still in development.

Mental Health Aged Care Partnership Initiative (MHACPI)

The MHACPI pilot services are within residential aged care facilities, and function as purposed designed “Special Care Units” within the facility, operated by the residential aged care provider. Specialist consultation-liaison and case management support is provided by SMHSOP. The person is supported through the MHACPI “Special Care Unit” to transition to mainstream residential aged care. An evaluation of the MHACPI demonstrated that the model can successfully deliver quality care for older people with severe BPSD and/or mental illness within a mainstream residential aged care setting, improving their quality of life, and their access to long-term, community-based care. The cost-effectiveness of the model has also been demonstrated through a further evaluation.

Resourcing

Residential aged care facility staffing with specialist input from SMHSOP (old age psychiatrist and / or other members of multidisciplinary team). A MHACPI economic evaluation has examined the appropriate funding model and arrangements for MHACPI services.

Success factors

  • A well-designed Service Agreement (developed through collaboration and negotiation) and partnership between the residential aged care provider and the SMHSOP / Mental Health Service
  • Operational factors such as a committed residential aged care provider and board of management, effective clinical advisory committee with clearly defined functions and processes, and the ability to access on-call support staff as required
  • Committed and skilled staff, with appropriate (multidisciplinary) training, experience and expertise (and low staff turnover)
  • Strong, effective MHACPI leadership and teamwork
  • Strong training and support for MHACPI staff
  • Use of psychosocial approaches and alternatives to medication
  • Access to on-call staff support when required
  • Specialist support from psychiatric services complemented by the services of an interested GP
  • Appropriate, purpose-designed facility and environment
  • Design of effective and efficient data collection and reporting.

Models in operation

Mental Health Aged Care Partnership Initiative (MHAPCI) – 2 pilot services:

  • HammondCare (South Western Sydney LHD)
  • Catholic Health Care (Sydney LHD)