Dear  ,

Kaya, Kia ora and Greetings from the Editor – Dr Noel Collins

Dear all,

Kaya and welcome to the fourth edition of Australasian OAP – and our first issue for 2026. Happy New Year.

This edition features a recap of the recent Fremantle conference and a career reflection from Dr Neville Hills.

This will be my final edition as editor. Forums such as this newsletter play an important role in promoting our subspecialty and bringing members together across Australasia.

Thank you to those who have contributed and supported the newsletter, and I look forward to seeing it continue under new editorial leadership.

Best,
Noel

View from the Chair – Dr David Lie

Moving into 2026 the FPOA is in a healthy position with a membership of 356 Tier 1 members and 284 Tier 2 members. In addition, advanced training in POA remains a strong option for trainees. Whether the numbers (see below) can hope to meet the future demand remains to be seen.

On a more sombre note, it has been challenging to improve our advocacy for the expansion and retention of older adult services whether public or private within the current political climate.

Activities we have undertaken include:

• reaching out to various leaders within the College
• reaching out to other Colleges
• looking for advocacy from relevant NGOs
• including a number of complimentary conference attendances to early career doctors and medical students within the Psychiatry Interest Forum (PIF)
• regularly contributing to a number of College position statements and submissions
• increasing the value of our prizes (currently unable to increase the number of prizes)
• inaugurating a Higher Degree through Research meeting at our meetings
• trying to ensure representation of POA where possible at key College meetings

I’m happy to receive your suggestions in this area.

Changes to the training scheme have been an additional concern for many of you. The key issue has been the status, quality and quantity of POA activities within basic training. Basically, how to ensure a sufficient chunk of activities which are mandatory on the one hand, flexible enough for regional trainees bi-nationally to complete without creating a bottleneck and funding or voluntarily providing the supervision required to make these meaningful experiences.

Achieving this aim is constrained not least by the speed of finalisation of curriculum and syllabus within various RANZCP Committees.

Meanwhile in 2026, I will be meeting with the Chair of the CL Section (which includes 130 of our current FPOA members) to look at the ensuring the quality of the many POA EPAs which are currently being signed off in mandatory CL terms (especially BPSD).

In 2025, the FPOA committee agreed to keep the old age membership fees at $80 rather than increasing, unfortunately this was not reflected in the fees paid in 2025. Therefore, the FPOA membership fee charged for 2026 will be lower at $62 to reflect you receiving a refund of $18 that was overpaid in 2025. Membership fees will return to $80 in 2027.

We had a great turnout and wonderful program at the 2025 Faculty of Psychiatry of Old Age (FPOA) Conference. Many thanks to Dr Noel Collins and his enthusiastic Committee and once again to Katrina Huntington and her RANZCP Events Team colleagues, as well as our Dianne Gregson our FPOA Secretariat, who made the whole thing possible. Read Dr Noel Collins' recap to see what you missed.

See you at our Annual Conference in Cairns 16-18 September 2026!

Finally, our FPOA executive members represent the views and needs of the Branches and advanced Trainees. Please contact them especially if you have specific suggestions or requirements. We have no one representing us from the Northern Territory – even an occasional appearance would be great. Please contact Ms Dianne Gregson at dianne.gregson@ranzcp.org.

The Bi-national Executive aside from myself is currently:

• Dr Meenal Aggarwal - VIC Jurisdictional Member
• A/Prof Yoram Barak - NZ Jurisdictional Member
• A/Prof Gary Cheung - Chair, SATPOA (NZ)
• Dr Matthew Fasnacht - TAS Jurisdictional Member
• Dr Neeraj Gupta - SA Jurisdictional Member
• Dr Zain Hindawi - ACT Jurisdictional Member
• Dr Duncan Neilson - NZ Jurisdictional Member
• Dr Megan Nitz - QLD Jurisdictional Member
• A/Prof Anne Wand - NSW Jurisdictional Member
• Dr Shannan Woods - Trainee Delegate (WA)

Features: Updates from the states and New Zealand

Professor Brodaty’s lifelong commitment to dementia began with personal experience. In 1972, his father was diagnosed with Alzheimer’s disease at the age of 52, at a time when dementia was poorly recognised, under-researched, and largely unsupported. For people living with dementia and their families, there were few services and little understanding. This experience became the catalyst for a career dedicated to improving diagnosis, care, and outcomes for those affected by the condition.

In 2012, Professor Brodaty co-founded the Centre for Healthy Brain Ageing, leading research that has significantly advanced global understanding of dementia risk and prevention. His landmark Maintain Your Brain trial demonstrated that practical, affordable, and targeted interventions can meaningfully delay the onset of cognitive decline and, in some cases, prevent dementia altogether.

A mentor, elder statesman and inspiration for dozens of old age psychiatrists around the world, Professor Brodaty continues to make a difference in the lives of older adults globally. Professor Brodaty continues to lead with impact through clinical innovation, research excellence, and advocacy. He has reshaped how dementia is understood and managed, helping to chart a future in which dementia is treated earlier, more effectively, and with greater hope for prevention.

Prof Brodaty’s work has influenced clinicians, researchers and government policy, alongside changing societal attitudes towards dementia.

NSW FPOA held the webinar “Managing substances, sleep and pain: clinical tips for working with older adults”.

We had almost 250 registrants across Australia and New Zealand. Thank you to our excellent speakers, Prof Apo Demirkol, Dr Swapnil Sharma and Dr Elie Matar.

We are planning another webinar 8.30–11 am EST, 26 March 2026 with the theme of Dementia: practical aspects of management. We welcome attendance from bi-national FPOA and other College Fellows and trainees, nursing, allied health and aged care colleagues. Look out for more information about this event featuring much loved local (Prof Henry Brodaty and A/Prof Samantha Loi) and international (Prof John O’Brien) luminaries from our specialty.

A/Prof Anne Wand
Chair, NSW FPOA

New Zealand

Read 'Time for psychiatry of the advanced age' by A/Prof Gary Cheung, A/Prof Anne Wand and Dr Rod McKay.

Message from SATPOA Chair – A/Prof Gary Cheung

It was wonderful to see many of you at the FPOA Conference in Fremantle last November. My sincere thanks to Dr Noel Collins for organising a fantastic conference, including a dedicated half-day session for POA advanced trainees.

Changes in Directors of Advanced Training (DoATs)

There have been recent changes to POA DoATs across Australia and New Zealand.

• ACT: A/Prof Jeffrey Looi resigned from his DoAT role in early 2025. Dr Varun Kumar has recently appointed as DoAT for ACT.
• New Zealand: Dr Elizabeth Fussell has stepped down from her DoAT role, and Dr Adam Sims’s DoAT delegate role (Lower North Island) has been disestablished. These roles have been replaced by a co-DoAT model, with Dr Matthew Croucher and Dr Joanna Wang appointed as Co-DoATs for New Zealand.

We would like to take this opportunity to sincerely thank Jeffrey, Elizabeth and Adam for their service and contributions to POA advanced training.

Current POA Directors of Advanced Training

• Victoria: Dr Francine Moss (Deputy SATPOA Chair)
• Western Australia: Dr Fiona Krantz, Dr Natalie Shulman (covering Fiona’s long service leave)
• Australian Capital Territory: Dr Varun Kumar
• Tasmania: Dr Matthew Fasnacht
• South Australia: Dr Richard Weeks
• New South Wales: Dr Douglas Subau
• Queensland: Dr Shirlony Morgan
• New Zealand: Dr Matthew Croucher and Dr Joanna Wang (Co-DoATs)

Education and training developments

At present, there has been limited progress on POA advanced training education improvement initiatives, as these are on hold while awaiting direction from the College’s newly appointed New Fellowship Program Taskforce.

The Taskforce is responsible for setting the strategic direction and developing the high-level design of a new Fellowship program for psychiatrists across Australia and New Zealand. Further information is available on the RANZCP website.

2026 Bi-national Formal Education Lecture Series

Dates for the 2026 Bi-national Formal Education Lecture Series have now been confirmed. Many thanks to Dr Francine Moss and Dr Douglas Subau for putting the programme together.

At the time of writing, online access links are being updated and should be available closer to the first session in March. Please check with your local DoAT for details.

Time: 1 pm Thursdays (Melb/Syd time)

26 March – Management of BPSD – Steve Macfarlane 

21 May – Cognitive testing (note 1.30 pm) – Jeffrey Looi

23 July – Anxiety Disorders in Older People – Gerard Byrne

20 August – Management of dementia (note 1.30 pm) – Henry Brodaty

FPOA Conference, Cairns 16–18 September 

22 October – Vascular Hypothesis of Late-Life Depression – Osvaldo Almeida

3 December – ECT / TMS – Brett Simpson & Kieren Owens

If you have any questions about POA advanced training, please contact the College TrainingHelp@ranzcp.org.

RANZCP FPOA Conference 2025 Recap - Dr Noel Collins

Higher Degree by Research in Psychiatry of Old Age: What support do members want?

The Bi-national Faculty of Psychiatry of Old Age recently conducted a short survey to better understand the research interests and support needs of members who are undertaking, or interested in undertaking, a Higher Degree by Research (HDR).

We received 34 responses from across all Australian states and New Zealand, including 8 trainees and 26 Fellows/Affiliates. There were no responses from the ACT or Northern Territory. Thirteen respondents were currently completing or had completed a PhD, MD, or master’s degree, while the remainder had not yet started an HDR.

What support do respondents want from FPOA?

Respondents were very clear and consistent about the types of support they would value. Key themes from the raw responses included:

• Help getting started in research, including understanding how to begin and navigate research pathways
• Access to supervisors and mentors, particularly experienced researchers in psychiatry of old age
• Networking and linking with others who have similar research interests, including across Australia and New Zealand
• Opportunities for collaboration, especially multicentre studies, subject recruitment, cohort studies, clinical trials, and clinical research
• Research skills development, such as workshops or sessions on methodology, grant writing, and ethics
• Funding-related support, including information on grants, scholarships, and funding opportunities
• Research visibility and dissemination, including opportunities to present research at FPOA conferences and symposia
• Practical research infrastructure support, such as access to research centres, ethics processes, and research libraries
• Awareness of opportunities, particularly for those not in permanent public-sector roles
• Mentorship and coaching, especially for novice researchers seeking guidance and confidence-building

Overall, respondents expressed a strong desire for mentorship, connection, funding awareness, and structured research support through FPOA, alongside opportunities to build a collaborative POA research community.

Interested in joining or contributing?

We will have a video conference call with members who responded to the survey during the first half of 2026. If you would like more information about this emerging HDR and early-career research network, or would like to join or contribute, please contact:

• A/Prof Anne Wand – anne.wand@health.nsw.gov.au
• A/Prof Gary Cheung – g.cheung@auckland.ac.nz

We look forward to growing this network and strengthening POA research across Australia and New Zealand.

A career reflection by Dr Neville Hills

We are meeting near the site of Western Australia’s first “lunatic asylum”: Scott’s warehouse in Fremantle, which held 32 people in the 1860s. Warehousing of people with mental illness continued for decades. An asylum built by convict labour in 1865 became scandalously overcrowded, and by the early 1900s Claremont Hospital opened – still shaped by 19th-century policies and English traditions of architecture and management. Claremont became the largest mental health facility in WA, serving the whole state until 1982. Heathcote Hospital opened in 1929 with 110 beds for “recoverable patients”; many others were sent to Claremont.

I completed medical training in 1957 with the first sixth-year cohort of the new WA Medical School and started at Royal Perth Hospital. By 1962 I was an untrained psychiatry registrar, and in 1964 I joined Claremont as a medical officer. At that time Claremont housed more than 1,500 patients, yet only three doctors had psychiatric qualifications. On my first day I was handed a key, shown three wards – around 300 patients – and left to get on with it. After failing a locally improvised DPM exam, I left for London with my young family in 1967, gained the Conjoint DPM, and entered forensic psychiatry. Returning to Perth, I worked in a new day hospital (since demolished) and then spent five demanding years as psychiatrist to the Department of Corrections, based at Fremantle Prison and travelling statewide.

In 1972, Superintendent Harry Blackmore divided Claremont into Graylands Hospital for acute admissions and Swanbourne Hospital for more than 400 people including those with intellectual disability, alcohol dependence, epilepsy, brain injury, long-stay “graduates,” and those labelled “senile.” Peter Reed carried the enormous task of running Swanbourne and developing psychiatry for seniors. I joined him in 1978 and became superintendent when he retired. My first challenges were immediate and practical: rotten meat delivered to the kitchen, and a waiting list of 40 admissions – some people already dead, others no longer needing care. From geriatrician Dick Lefroy I learned the value of honest waiting lists and clear thresholds. We decided we would not admit patients unless assessed and approved by our own staff. It was unpopular with some colleagues but indispensable.

“Admission for assessment” was often a euphemism for placement. We insisted on assessing people where they were – home, hospital, or facility –and offering admission only when necessary and when we had the resources to treat and discharge. Treatment and turnover were our core business; keeping seniors well and out of hospital where possible was the wider aim. Swanbourne had to stop being a “drop-off and forget” service. In 1979, Fred Bell produced a frank report on Swanbourne’s many faults. At the same time, land values and politics intruded: Swanbourne sat on prime development land. A proposed 350-bed replacement hospital at Shenton Park met swift opposition – why move two kilometres from one asylum to another?

A turning point came when Bill Miller, an experienced NSW architect, was invited to review the plans. He reframed the mission entirely: enabling older people to live independently at home wherever possible, and when not, ensuring care environments respected privacy, dignity, needs, and wishes. That philosophy shaped everything that followed – service models, ward design, and relationships with families and community services. In 1982 Dr Ann Warcholak arrived as deputy psychiatrist-superintendent, a trained psychogeriatrician from Edinburgh. Her leadership transformed clinical flow: getting people well enough to leave created space for those who truly needed admission.

A strong multidisciplinary, community-focused model developed. Social workers and community nurses led domiciliary assessments, with medical input as required. Ward rounds became relentlessly practical: what is keeping this person in hospital? We adopted a “least use of all drugs” philosophy, recognising limited benefits and real harms, supported by expert clinical pharmacy. Carer support was central to success, and in 1981 WA’s first Alzheimer’s Association began, encouraged by our social workers. We believed environments influenced behaviour and designed wards to support rehabilitation rather than institutionalisation.

One practical outcome was the Eden Hill Cluster Homes in 1982: seven new, single-level three-bedroom houses in the suburbs for people who could live in a normal home environment with support. The model restored living abilities and reconnected people with community life. Later evidence would confirm what we observed: clustered, domestic models improve quality of life and reduce hospital use without increasing whole-of-system costs. Yet the model proved too far ahead of its time. Administrative reorganisations restricted community assessment and follow-up, data collection was curtailed, and admission policies tightened. A service model that could have guided statewide development was slowly dismantled.

Over subsequent decades, resources were steadily eroded or repurposed. In the mid-1980s there were around 328 psychogeriatric beds; on my last estimate there are now about 152. Lodges designed for subacute rehabilitation are now forced into acute roles under the Mental Health Act as other options disappear. Facilities age and require thoughtful renewal, yet I fear “modern standards” will be used to justify blunt replacements rather than careful improvement. Academic leadership did grow – Hans Förstl, Osvaldo Almeida, and others strengthened education and research – but seniors’ mental health cannot function without strong multidisciplinary teams: nursing, social work, occupational therapy, psychology, physiotherapy, and clinical pharmacy.

The last WA Seniors Mental Health Strategy was published in 1998–27 years ago. WA’s population has grown from 1.3 million in 1981 to around 3 million today. The ageing “tsunami” has arrived. When need exceeds what families or facilities can manage, timely specialist consultation – and admission when necessary – should be available. Defaulting to crisis ED presentations, blocked beds, and ambulance ramping is poor care. We already know what works: stepped care, prompt assessment, mobile multidisciplinary teams, and practical supports that keep people at home wherever possible. Billion-dollar hospitals alone cannot do that.

Seniors’ mental health is a demanding and rewarding branch of psychiatry, drawing equally on medical, psychological, and social expertise. It also delivers system benefits by reducing avoidable admissions and bed-block. The challenge is making that value visible to governments, media, and the public. In closing, I’ll remind you: old psychiatrists never die – they just shrink away.

Elder abuse

We have recently launched a Research Topic (article collection) in collaboration with Frontiers in Psychiatry, focused on highlighting current understanding and gaps in the field of research on the abuse of older people. We are particularly interested in the submission of original research, reviews and perspective articles addressing the following themes:

• Risk factors and potential signs of the abuse of older people, as well as tools designed to improve the detection of older adults at risk of abuse
• Association between the abuse of older people and mental health outcomes
• Protective factors and preventative strategies, as well as consequences (e.g., quality of life, cognitive changes)

Additional information on the research topic.

Should you have any questions about a potential contribution, you are welcome to reach out. The deadline for manuscript submissions is March 2026 however we may be able to offer a deadline extension should this be required.

Please note that as an open access journal, manuscripts accepted for publication are subject to article processing charges. These vary based on the article type you are planning to submit, however the journal team at Frontiers in Psychiatry are happy to help if you require any additional information on this or the fee support options available to contributing authors.

Please feel free to reach out to them directly at psychiatry@frontiersin.org.

Celebrating creativity in people living with dementia

Led by Tauranga geriatric psychiatrist Dr Bronwyn Copeland, the initiative reflects growing evidence that neurodegenerative illness may, in some individuals, be associated with the emergence of creative expression. Research from UCSF has documented how changes in brain networks can unmask artistic abilities in people living with dementia an observation with important implications for how clinicians conceptualise preserved strengths, identity, and personhood in later-life mental illness.

The gallery’s first exhibition features Ian Cameron, a man living with dementia who began creating visual art only after his diagnosis. His instinctive, free-flowing work challenges deficit-based narratives of dementia and highlights the therapeutic and relational value of creative expression. The gallery itself is located within the Mental Health Service for Older Persons waiting area at Tauranga Hospital, signalling a deliberate effort to normalise creativity within clinical environments.

Gallery 190 NZ builds on the success of Artful Mind, a community collaboration pairing people with dementia and local artists. Together, these initiatives illustrate how multidisciplinary partnerships – spanning psychiatry, community organisations, artists, and families – can enhance engagement, dignity, and meaning in dementia care.

For old age psychiatrists, Gallery 190 NZ provides a practical example of how arts-based approaches can complement clinical care, support carers, and foster more humane service cultures. Ongoing collaboration with UCSF, including shared exhibitions and cross-Pacific exchange of artworks, underscores the potential for international learning in this space. Read more.

Advocating for Climate Action: Doctors for the Environment Australia

DEA advocates for climate action through political engagement, peaceful protest, media advocacy, correspondence, petitions, presentations and public events. Across Australia, DEA members are working to protect human health and the environment from the well-established harms of fossil fuels, including coal, oil and gas. The combustion of fossil fuels is a major driver of climate change and a direct cause of preventable morbidity and mortality. Coal, oil and gas extraction and use release greenhouse gases such as carbon dioxide (CO₂), methane (CH₄) and nitrous oxide (N₂O). The accumulation of these gases in the atmosphere intensifies the greenhouse effect, trapping heat and driving global heating and climate instability.

In addition to their climate impacts, coal and so-called “natural” gas are major sources of hazardous air pollution. Mining and combustion release pollutants including nitrogen oxides, ground-level ozone and fine particulate matter (PM2.5), which are associated with increased rates of asthma, chronic respiratory disease, cardiovascular disease and malignancy, including childhood leukaemia. Evidence also links these exposures to adverse pregnancy outcomes, neurodevelopmental impacts in children, and cognitive decline in older adults.

Governments have an ethical and public health responsibility to act urgently. With 2023 confirmed as the hottest year on record, and temperature extremes accelerating in Australia and globally, delay is no longer defensible. The transition to clean, renewable energy is both feasible and necessary; the principal barrier is political will.

DEA advocates for governments to prioritise population health by prohibiting all new coal, oil and gas developments and introducing national restrictions on fossil fuel advertising and sponsorship. Protecting the health of Australians must take precedence over the commercial interests of the fossil fuel industry.

For more information on the vital work of DEA or to join, please visit the DEA website.

Dr David Lie
Chair, Bi-national Faculty of Psychiatry of Old Age Committee