They are often really at risk and struggle to find support, particularly in rural and regional areas.

But there is no age limit to mental health issues, and unfortunately elderly people living in aged care homes are particularly at risk.

This week's Four Corners program has provided shocking examples of where aged care can go wrong.

But our alarm is not just in such distressing cases of poor practice. It's in how we as a community view wellbeing, and the skills and resourcing we allocate.

That's why we are currently urging the federal government to include mental health care in its terms of reference for the recently-announced Royal Commission into Aged Care.

Because the numbers and the lack of focus now are a big worry.

The Australian Institute of Health and Welfare tells us that more than 47 per cent of people living in aged care homes have symptoms of depression, compared to just 10 to 15 per cent of older people living in the community.

The reasons are many and varied – anxiety and depression associated with physical health problems, chronic pain, side effects from medications, social isolation and loss.

What is most heartbreaking, and unfair though, is that many people experiencing these symptoms in aged care don't get the care they should be able to expect, and which would be available to them in the community.

Yes, sadness is common in older people who experience the onset of a physical illness or personal loss, and moving into aged care is no easier than any great transition in life.

But depression is different and is not a normal part of ageing.

This is something we all need to know –  families and friends, aged care staff, GPs, hospital personnel and other practitioners.

Another worry is reports that some aged care residents are being ‘overtreated’, in both dosage and the type of medication they’re given.

It’s known as ‘chemical restraint’, where medication is chosen to manage behaviour rather than treat a debilitating illness.

There are many reasons for this: aged care staff are very stretched anyway and often have limited skills and training, particularly when it comes to understanding and managing confusion over the ‘three Ds’ – depression, dementia and delirium.

But there has also been a big inequity in access to mental health treatment services among older Australians.

As Fairfax papers reported last year, aged care residents have been ineligible for the same Medicare-funded psychological treatments that other Australians receive, that is via the GP mental health treatment plans and therapies provided through the Better Access program.

For too long the only mental health or wellbeing support they were likely to receive were through visits from volunteers or chaplains or the kind word and deeds of personal care staff.

These are important  – in fact critical – but they are not enough for the diagnosis and management of complex mental health issues.

And this is particularly a problem in rural and regional areas, where there is a dual problem of not enough aged care beds and struggles to attract staff.

Government needs to fund a strategy to increase the mental health knowledge and literacy of front-line staff in aged care and to make aged care an attractive career option for graduating psychiatrists, nurses, psychologists and allied health professionals – all of whom are in short supply in the sector.

There is some good news.

This year’s Federal Budget announced a More Choices for Longer Life package to provide new mental health services for people living in residential aged care facilities.

We welcome the initiative but know it will only scratch the surface.

The $82.5 million allocated will be spread over four years and across 31 primary health networks (PHNs).  

Our worry is that places that are already underserved, like rural and regional Victoria, will continue to miss out.

People living in an aged care setting should be entitled to access the same care as everyone else. We should not be rationing mental health services for older Victorians.