Wollongong resident Liliana Panto has helped care for her brother since he was diagnosed with schizophrenia over 50 years ago.
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Yet after a stroke five years ago, her now 72-year-old brother Osvaldo requires residential aged care - and therein lies the problem.
Due to his mental illness and associated behavioural issues, Mrs Panto has been unable to find a place for him at a home in the Illawarra.
She's been forced to send him to Sydney, where he resides at Montrose Aged Care Centre - a Salvation Army home which provides care for older men with behavioural and mental health concerns.
It's a great facility, and Mrs Panto wants to know why there isn't one like it in the Illawarra.
"Montrose is fantastic, but it takes me six to seven hours to make a round visit," she said.
"And my brother frets when no-one is there to visit him; he's used to having us around.
"He has a heart of gold but can get upset - the more we spend time with him, the calmer he is."
Mrs Panto and her brother came to the Illawarra with their parents in 1956, initially living at the Unanderra hostel.
Their father worked in the steelworks, but was diagnosed with cancer and died within four years of their arrival.
"Mum never remarried, just looked after us. When I was married we stayed living with my mum to help her with Osvaldo," Mrs Panto said.
"He's had electric shock therapy and been hospitalised many times but he'd been able to manage his condition with a psychiatrist and medication.
"Yet after his stroke he needs a higher level of care."
Mrs Panto said social workers from the Illawarra Shoalhaven Local Health District (ISLHD) had tried to help her find Osvaldo a home close by, to no avail.
"None of the local aged care providers had a place for him - surely there's other older people with mental illness who need care?" she asked.
The aged care system, including nursing homes, is fully funded, regulated and legislated by the Federal Government.
However a spokesperson for the Department of Health said it did not "prescribe admission practices for residential aged care homes".
"Admission to any aged care home is a matter between a person seeking care and the approved provider, taking into account a range of factors, including whether a provider has the appropriate staff and facilities to manage the care needs of the individual," the spokesperson said.
Comment was also sought from several aged care providers in the Illawarra.
A Warrigal spokeswoman said the provider couldn't care for older people with "significant mental health issues .. due to government priorities and resourcing".
Others, like Marco Polo, said they had specialised units for people with dementia - but not specifically mental illness.
IRT Group CEO Patrick Reid said the organisation's care centres and home care services did provide care to older people living with mental illness.
"We have a psychologist on staff working across our six Illawarra aged care centres supporting residents with a range of mental health conditions including anxiety, depression, paranoia and personality disorders," he said.
"While we do not have specialist units, our care workers are aware of the mental health needs of our residents and customers and how to effectively care for them in ways that protects their dignity and mental health.
"We also seek additional support from external specialist services as needed."
An ISLHD spokesperson said while the district was not a provider of residential aged care, staff did work closely with aged care facilities when a referral was received.
"The ISLHD aged care service also works closely with our mental health service to provide assessment and referral for those people requiring support," the spokesperson said.
"ISLHD, via the Older Persons Mental Health team and Community Mental Health teams, also provide support to residential aged care facilities to assist with development and management of mental health care plans, provide support for residents and their families, and education for staff.
"These teams accept referrals directly from aged care providers for non-urgent mental health assessment and referral."
Statewide, the NSW Government is funding the expansion of mental health-residential aged care partnership services under the Pathways to Community Living Initiative. This is focused on creating pathways into community care for people experiencing long stays in hospital.
Meantime the Federal health department spokesperson said the government was providing $102.5 million over four years to improve supports for those in aged care experiencing mental health issues.
"The 'Improved access to psychological services in Residential Aged Care Facilities' measure aims to provide access to localised in-reach mental health services for people with, or at risk of, mental illness in aged care homes," he said.
However the spokesperson added: "For those with serious mental illness, however, residential aged care may not be the most appropriate option.
"In these circumstances, there are often state government run services, such as the NSW Government's Older People's Mental Health Services, which provide specialist care (including in-patient services) for people with mental health concerns that are not able to be managed in the community."
