Carers' experiences accessing mental health care for older people in South Australia: Mapping the journey

Mental health care for older people is primarily delivered in the community and is largely dependent on input from informal carers. Australian mental health policy encourages partnerships between consumers, carers, and service providers to facilitate service access, coordination, and positive experience of care. In reality, however, carers often lack information and support from services and the consequences of care burden can impact on their own health and capacity to fulfil caring tasks. Older people with mental health problems often require input from a range of services across sectors, which can be challenging for consumers and their carers to navigate. Little is known about carers' experiences in obtaining appropriate care and support from such a broad range of services. This paper explores older people's journeys to and through mental health care from the carers' perspective. Nine in‐depth interviews were conducted with eleven rural carers of people with a mental health concern. Each journey was mapped to illustrate key points in the journey, people involved, key actions, carer experience, and suggested improvements. Two carer journeys are presented (one who successfully negotiated a care journey and one unsuccessful). Framework analysis was used to explore carers' perceptions of enablers and barriers to accessing care. Results highlighted the significant role carers had in navigating options and operationalizing care. Enablers included carer knowledge and roles and the presence of case reviews facilitating collaboration between services and with carers. Barriers included carer issues (mental health literacy), consumer issues (readiness for services), and worker issues (confidentiality). The results indicated that changes need to occur at the worker level (increased communication between mental health workers and carers) and service level (training for staff in interpreting confidentiality and privacy laws). It is concluded that to best manage the health and care of an older person, carers should be considered key partners by mental health nurses in care planning that crosses the service sectors.