Sane conducts action research to help people living with mental illness and provides and extensive range of information on mental illness through innovative print and multimedia resources. They are concerned with a wide range of mental illness especially psychotic disorders such as schizophrenia. Sane has won a number of international awards and campaign for improved services and attitudes. They also rely entirely on donations and grants.

Senior Service - How well do we care for older Australians with a mental illness?

In this special feature (Sane News 11) we look at the range of issues which affect our 'senior citizens' living with mental illnesses such as schizophrenia, bipolar disorder, anxiety disorders, and depression - which is especially prevalent among older persons.
The report will not cover illnesses such as dementia, as the issues involved are so different, and merit a study devoted exclusively to them.

Our ageing population
By the year 2001, 18% of the population will be over 60.
By the year 2021, a quarter of all Australians will be over 60!

With around 3% of all adults affected by psychiatric disability, these figures indicate a massive increase in need for a whole range of services and support for this group.

The institutions' legacy
Australians over 65 with a mental illness are likely to have spent long periods of their lives (perhaps many years) living in the psychiatric institutions.

The old psychiatric hospitals, now largely closed down, have left a complex legacy. They undoubtedly encouraged a culture of dependence and disempowerment among those who stayed there, so that psychiatric disability was often compounded by lack of confidence, knowledge and skills when discharged to live 'independently' in the community.

People who have spent long periods in psychiatric institutions are also more likely to be on higher doses of the older antipsychotic medications - with increased risk of long-term side-effects. Many have also been effectively 'reinstitutionalised' in inner-city boarding houses, with minimal clinical or disability support. While some of these are served by excellent support teams, others have been described as 'warehousing people till they die'.

Physical health
The physical health of people with a mental illness is a matter of serious concern - this is especially true of older people.

Research increasingly shows that people with a mental illness have poorer physical health than the general population. This becomes even more serious in older years as chronic disorders such as osteoporosis or heart disease develop, for example. There is even evidence that this group die younger of natural causes than the average.

A question of attitude
Negative attitudes are often a barrier to effective care.

Whether deliberate or not, attitude plays a significant role in services and care for older people with a mental illness. Anxiety and depression are often viewed as 'part of growing old', rather than treatable conditions. There may even be unspoken, unconscious attitudes that resources are better allocated to young people with their whole lives ahead of them.

© SANE Australia 1999

Reproduced with permission from SANE News 11 (Winter 1999).

Phone :	03 9682 5933
Fax :	03 9682 5944
Email :	sane@sane.org
Website :	www.sane.org
Contact :	Ms Barbara Hocking Executive Director

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