Regional responses to the challenge of delivering integrated care to older people with mental health problems in rural Australia

ABSTRACT

Objective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people.

Methods: Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration.

Results: Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery.

Conclusion: We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities.

KEYWORDS:

• Older person
• mental health
• policy
• rural
• integrated care
• Australia

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Acknowledgments

The research reported in this paper is funded by the Australian Primary Health Care Research Institute. The information and opinions contained in it do not necessarily reflect the views or policy of the Australian Primary Health Care Research Institute or the Commonwealth of Australia (or the Department of Health and Ageing). Additional funding was also provided by a grant from the Nurses’ Memorial Foundation of South Australia and the Faculty of Medicine, Nursing and Health Sciences, Flinders University of South Australia. The authors are grateful to the service providers who participated in this study.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Commonwealth of Australia.