On this page
- What are OPMH services?
- OPMH service plan
- Governance of OPMH services
- OPMH community-based services
- OPMH hospital-based services
- Community OPMH partnership services and programs
What are OPMH services?
NSW Older People’s Mental Health (OPMH) services provide public specialist mental health clinical care generally to people aged 65 years and over. People under 65 years old, including Aboriginal people aged 50 years and older, can also use this service if it is suitable for their needs.
Caring for population groups with specific needs
OPMH services include:
- multidisciplinary community services
- acute and non-acute inpatient units/services
- community OPMH partnership services, including residential aged care services, and programs.
OPMH services are delivered by a range of health professionals with skills and expertise in mental health problems affecting older people and people with age-related frailty. This includes specialist old-age psychiatrists, nurses, psychologists, occupational therapists, diversional therapists and social workers.
Functions of OPMH services include:
- specialist mental health assessment
- care planning
- short and longer term clinical management
- clinical advice to other key services, health professionals and programs
- collaborative activities to support early intervention and recovery for older people with mental health problems.
Among older people with mental health problems, certain population groups have specific needs regarding service appropriateness and accessibility. These include:
- older Aboriginal people
- older people living in rural and remote communities
- older people from CALD backgrounds
- residents of aged care facilities
- older people with co-existing mental health and alcohol & other drug issues
- older people with co-existing mental health problems and intellectual disability
- older people in the criminal justice system
- older people who are homeless or at risk of homelessness
- older people living in severe domestic squalor
- older lesbian, gay, bisexual, transgender and intersex (LGBTI) people
- families and carers.
OPMH service plan
The NSW Older People’s Mental Health Services Service Plan 2017-2027 is intended to guide OPMH services over the next 10 years. The Plan outlines the purpose, scope, target group and key elements of OPMH services, the context in which they operate and current developments in the service environment. It identifies evidence-based service models and key strategic priorities for the development, delivery and improvement of OPMH services.
Governance of OPMH services
OPMH services are part of local health district (LHD) mental health services. The OPMH Policy Unit of the Mental Health Branch of the NSW Ministry of Health works closely with state-wide OPMH committees to provide strategic guidance to OPMH services and OPMH more broadly. OPMH services are guided by the NSW Service Plan for Older People’s Mental Health Services 2017-2027.
OPMH community-based services
Older People’s Mental Health (OPMH) Community Services are available in each local health district. They are a key component of OPMH services, and are central to the provision of coordinated services to older people with mental health problems.
The Specialist Mental Health Services for Older People Community Model of Care Guideline (2017) and accompanying Key Features of the Model of Care defines how community services for older people with mental illness should be delivered, saying they should be:
- attentive to consumers’ biopsychosocial needs
- delivered in partnership with consumers, carers, general practitioners and other services and supports.
The implementation of the model was supported by additional recurrent funding to local health districts (LHDs) from 2017-18 under the NSW Mental Health Reform. Read Specialist Older People's Mental Health Reform.
The Evaluation of the NSW Older people’s mental health (OPMH) community services model of care – Summary Report presents the key findings and recommendations of the external evaluation of the model.
OPMH hospital-based services
Older people’s mental health hospital-based services include both acute inpatient and non-acute inpatient services.
OPMH acute inpatient services
OPMH acute inpatient services provide specialist mental health care for people who present with acute, severe symptoms of mental illness. Acute mental illness in older people may be accompanied by co-existing physical health or medical issues and is sometimes complicated by delirium. These services may be discrete facilities or sub-units within acute mental health facilities or acute hospitals.
OPMH acute inpatient services provide multidisciplinary assessment of a person’s mental and behavioural status, including physical health and psycho-social issues, and short term clinical treatment (voluntary or involuntary) for the acute phase of an illness which cannot be managed in the community.
The OPMH Acute Inpatient Unit Model of Care guides service improvement and development in existing units and informs planning for new units. The project report was released in 2012 and then was re-released in 2016 as a NSW Health Guideline.
OPMH non-acute inpatient services
OPMH non-acute inpatient services have a primary focus on intervention to reduce functional impairments that limit people’s independence, and to promote recovery.
They provide specialist clinical assessment, treatment and rehabilitation in an inpatient setting, where a person’s mental illness is not able to be managed in the community.
It is an expectation that consumers of these services will improve sufficiently for discharge to a mainstream service or community setting, with additional support from Older People’s Mental Health Community Services and other community services. Strong links with residential and community services are important in these services.
Transitional Behavioural Assessment and Intervention Service (T-BASIS) Units are included in this category. T-BASIS units are short to medium stay transitional/non-acute inpatient units providing intensive behavioural assessment and intervention for older people with severe Behavioural and Psychological Symptoms of Dementia (BPSD).
Community OPMH partnership services and programs
Partnerships with residential aged care providers
Older People’s Mental Health community services have traditionally provided some support for older people with mental illness and/or severe and persistently challenging behaviours associated with dementia who live in residential aged care facilities (RACFs), working in partnership with the aged care providers.
This way of working has been expanded over the last 10 years and there are now three kinds of mental health-residential aged care partnership services:
- specialist clinical outreach to generalist (or mainstream) RACFs
- Mental Health-Aged Care Partnership Initiative (MHACPI) transition units – specialist 8-10 bed units within a larger RACF - with specialist mental health clinical support by OPMH services
- specialist RACFs – residential aged care facilities with a specialist role with older people with mental illness and complex needs, with specialist mental health clinical support by OPMH services
Existing and newly established services include partnerships with Catholic Healthcare, Mission Australia, Southern Cross Care, RSL Lifecare, HammondCare and St Vincent de Paul.
It is expected that these mental health-residential aged care partnership services will continue to expand over the next 10 years under the NSW mental health reforms, the Pathways to Community Living Initiative (PCLI) and the NSW Older People’s Mental Health Service Plan.
Partnerships with mental health and aged care community care and support programs
By partnering with community care and support programs, OPMH services aim to improve access to mental health and/or aged care community care and supports for older people with mental health problems. Working in this way is important in meeting the complex physical, social, behavioural and psychological needs of an older person with mental health problems.