Trends in access to clinical mental healthcare by very old people in Australia since 'Better Access' commenced in 2006

Objectives To examine trends in access to mental healthcare by old and very old people since the commencement of Australia's Better Access Initiative in 2006.Methods Descriptive analysis of changes in access by people aged 75-84 and over 85 using data analysed and published by the AIHW.Results Since the introduction of Better Access, rates of access to specialist inpatient and community mental healthcare have reduced for those aged 75 years and older. The reduction is greatest for those aged 85 and over; with a 21% fall in community care access, 54% fall in inpatient access, and Medicare-funded psychologists and clinical psychologists access failing to rise above 1%. Rates of admissions by those 85 and older to inpatient care without specialised mental healthcare have increased by 92%, with emergency department presentations with mental health problems increasing by 33% since 2014-2015.Conclusions The oldest people in Australia have missed most benefits from mental healthcare reforms. The contribution of these changes to high rates of mental illness on entering residential aged care, persistent high suicide rates in older men, and increased use of emergency departments and general hospital beds demands further inquiry and action.