Mental health
Mental health services
Mental health services
is an Australia's health
topic
On this page:
What do we know about mental illness?
Mental illness is a major health concern in Australia, with an estimated 44% of people aged 16–85 experiencing a mental disorder during their lifetime, and 21% experiencing mental illness in any calendar year (ABS 2007, 2022). Mental illness can impact not just the individual, but also their family, friends and the community. Systemically, Mental and substance use disorders have been responsible for around 12% of the total disease burden and around 24% of the non-fatal disease burden in Australia over the last 2 decades (AIHW 2022a).
People with mental illness can access a variety of support services, which are funded and/or delivered by both the public and private sectors.
Mental health care and support is provided across a range of settings and services, including:
- specialised hospital services – public and private
- specialised residential mental health services
- specialised community mental health care services
- primary care services.
Health care professionals who provide treatment, care and support within the mental health system include:
- general practitioners (GP)
- psychiatrists and other medical practitioners
- psychologists
- nurses
- social workers
- other allied health professionals
- mental health consumer and carer workers
- other personal care staff.
This page presents the most recent quarterly data for mental health services activity and more comprehensive annual analyses on the volume and types of services used over time, funding and spending on these services, professionals providing mental health services, safety and quality monitoring and the impacts and experiences of mental health services across different domains of the Australian health system.
Mental health services activity
Timely information on mental health systems is crucial in providing an early picture of activity across the system and meaningful comparisons to historical data. Services activity monitoring can provide insights into how the mental health system is delivering services and responding to changing population needs and events, such as the COVID-19 pandemic, natural disasters and policy changes. National services activity data are presented on this page for the March quarter 2023.
Please note that this section replaces the previous Mental health impact of COVID-19 section. The previous section is available in the archived section of this site.
Medicare-subsidised mental health-specific services
Medicare-subsidised services are provided by psychiatrists, GPs, psychologists and other allied health professionals. They are delivered across a range of settings including hospitals, consulting rooms and at home (for example, home visits and telehealth).
About 20% of these services provided in the March 2023 quarter were delivered via telehealth, down from 32% in the same quarter in 2022 and 22% in 2021.
Pharmaceutical Benefits Scheme prescriptions
The Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) provide access to subsidised prescription medicines. For ease of reporting these programs will be aggregated and reported as ‘PBS’ on this page.
In the March quarter 2023, almost 11.1 million PBS listed mental health-related medications were dispensed. This was 2% higher than the same quarter in 2022 and 6% higher than in 2021.
National use of crisis and support organisations
Crisis and support organisations provide support to Australians experiencing mental health issues. There are a range of crisis, support and information services currently operating including Lifeline, Kids Helpline, Head to Health, ReachOut and Beyond Blue. National activity data for these organisations is reported here as contacts, representing service demand, and answered contacts, representing the total number of contacts answered by each organisation. Data for:
- Lifeline relate to phone calls
- Kids Helpline include phone, webchat and email contacts
- Beyond Blue include phone, webchat and email contacts
- data from July 2020 to December 2022 includes contacts and answered contacts for both the Beyond Blue main service and dedicated COVID-19 service
- ReachOut and Head to Health include the average number of website users per day, representing the average daily volume for website activity.
In the March quarter 2023 there were about:
- 278,900 contacts were made to Lifeline; 3% lower than the same quarter in 2022 and 1% higher than 2021.
- 79,100 contacts were made to Kids Helpline nationally; 10% lower than the same quarter in 2022 and 4% lower than 2021.
- 86,200 contacts were made to Beyond Blue nationally; this was 13% higher than the same quarter in 2022 and 16% higher than 2021.
- 6,800 ReachOut website users per day (on average); 2% lower than the same quarter in 2022 and 19% lower than 2021.
- 2,700 Head to Health website users per day (on average); 10% higher than the same quarter in 2022 and 20% lower than 2021.
For further information on the activity data presented above, including data sources, a list of key events related to activity and state and territory breakdowns, refer to the full Mental health services activity monitoring quarterly data section.
Service use
A large number of different types of services are accessed by people with a mental illness each year across the Australian health system. Selected annual findings are summarised below (Table 1).
| Service type | Volume | Selected findings |
|---|---|---|
|
Medicare-subsidised mental health-related services(a) For more, refer to Medicare-subsidised services |
13.6 million services to 2.8 million patients in 2021–22 |
|
|
Mental health-related prescriptions(b) For more, refer to Mental health prescriptions |
44.4 million prescriptions to 4.7 million patients in 2021–22 |
|
|
Public sector community mental health care service contacts For more, refer to Community services |
10.2 million contacts by 481,453 patients in 2020–21 |
Aboriginal and Torres Strait Islander patients received community mental health care services at more than 3 times the rate of non-Indigenous patients. |
|
Emergency department (ED) services (public hospitals) For more, refer to Emergency departments |
280,200 presentations in 2021–22 |
|
|
Overnight admitted patient hospitalisations For more, refer to Admitted patients |
280,700 hospitalisations in 2020–21 |
Depressive episode (15%) and Schizophrenia (13%) were the most common principal diagnoses for hospitalisations with specialised psychiatric care. |
|
Same day admitted patient hospitalisations For more, refer to Admitted patients |
57,260 hospitalisations in 2020–21 |
20% of same day hospitalisations with specialised psychiatric care in public hospitals had a principal diagnosis of Depressive episode. |
- Includes psychiatrists, GPs, clinical psychologists, other psychologists and other allied health services. These services are billed as mental health-related items, which underestimates the total mental health-related activity, especially for services provided by GPs.
- Prescriptions subsidised and under co-payment under the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme.
Source: Mental Health (AIHW 2022b).
Spending
About $11.6 billion, or $451 per person, was spent on mental health-related services in Australia in 2020–21; almost $11 billion of this was government mental health expenditure, representing 7% of total government health expenditure. Per person, spending on state and territory specialised public services increased (in real terms) by an annual average of 2% between 2016–17 and 2020–21. The total spending in 2020–21 included around:
- $7 billion, or $273 per person, spent on state and territory specialised services
- $1.6 billion, or $61 per person, spent on Medicare-subsidised services
- $619 million, or $24 per person, spent on PBS prescriptions.
Between 2016–17 and 2020–21, recurrent per person spending on state and territory specialised services increased (in real terms) from $257 to $273.
Refer to Expenditure on mental health-related services for more information.
Workforce
A variety of professions deliver care and support to people with mental illness, including psychologists, psychiatrists, mental health nurses, occupational therapists, social workers, GPs, counsellors and peer workers. Available data for some of these professions indicate that in Australia in 2021 there were about:
- 31,400 psychologists
- 4,000 psychiatrists
- 25,000 mental health nurses
- 2,600 mental health occupational therapists
- 2,600 accredited mental health social workers.
Refer to Mental health workforce for more information.
While professionals work across a range of settings, some work in specialised mental health care facilities. These specialised mental health care facilities are a key component in delivering mental health care in Australia. In 2020–21, there were about 36,700 full-time equivalent staff employed in state and territory specialised mental health care services.
Refer to Specialised mental health care facilities for more information.
Safety and quality
Safety and quality are important in all areas of the health system. Data are available that can be used to measure aspects of safety and quality in the Australian mental health care system, including:
- use of restrictive practices
- consumer perspectives of care
- change in mental health consumers’ clinical outcomes.
Seclusion and restraint
Seclusion is defined as the confinement of a patient alone in a room or area from which free exit is prevented. Restraint is defined as the restriction of an individual's freedom of movement by physical or mechanical means.
Reducing, and where possible, eliminating the use of seclusion and restraint is a policy priority in Australian mental health care and has been supported by changes to legislation, policy and clinical practice (RANZCP 2021).
Seclusion events in specialised acute public hospital mental health services halved from 14 seclusion events per 1,000 bed days in 2009–10 to 7 events per 1,000 bed days in 2016–17 and have remained steady at about that rate since (Figure 1).
Mechanical restraint events have remained at 1 event per 1,000 bed days of patient care since 2018–19. The use of physical restraint has remained relatively stable since 2015–16, varying between 10 to 12 events per 1,000 bed days of patient care (Figure 1).
Figure 1: Spotlight data of seclusion and restraint in Australia public sector acute mental health hospital services, 2009–10 to 2021–22
Spotlight data. Three line graphs showing seclusion rate (events per 1,000 bed days) in Australia from 2009–10 to 2021–22 and mechanical and physical restraint rate from 2015–16 to 2021–22.
The national seclusion rate halved from 2009–10 (14) to 2021–22 (7). This is real change in how services use seclusion.
Mechanical restraint has remained consistently low from 2 events per 1,00 beds days 2015–16 to 1 since 2018–19.
The physical restraint rate has stayed consistent from 11 events per 1,00 bed days in 2015–16 to 12 in 2021-22.
Source: National Seclusion and Restraint Database, Tables SECREST.1 and 4.
Refer to Seclusion and restraint for more information.
Patient-reported experiences of care
Measures of patient-reported experience collect patients’ views and observations on aspects of the care they have received. One such measure – the Your Experience of Service (YES) survey – has been implemented in New South Wales, Victoria and Queensland specialised mental health services. Each state has a method of administration that best suits local needs and, therefore, comparisons between jurisdictions with different methods should be made with caution.
In 2021–22, more than 24,500 YES survey responses were collected from 86 mental health service organisations across New South Wales, Victoria and Queensland.
In 2021–22, it is estimated that:
- 69% of respondents in New South Wales, 51% in Victoria and 47% in Queensland reported a positive experience of admitted care services
- 78% of respondents in New South Wales, 70% in Victoria and 80% in Queensland reported a positive experience of ambulatory (non-admitted) care services
- 80% of respondents in Victoria and 77% in Queensland residential care reported a positive experience of service.
Refer to Consumer perspectives of mental health care for more information.
Consumer outcomes of care
Clinical measures that capture information about the health and wellbeing of people during mental health service use can be used to report on whether consumers improve after receiving care. The National Outcomes and Casemix Collection includes data on outcome measures from all publicly funded or managed mental health services. In 2019–20, information for more than 200,000 people was recorded, representing 43% of consumers of public mental health services.
In 2019–20 clinician-rated measures showed Improvement outcomes for patients in:
- admitted (inpatient) care, at 58% (aged 11–17), 73% (aged 18–64) and 73% (65 and older) of episodes
- ambulatory (non-admitted) care, at 55% (aged 11–17), 52% (aged 18–64), and 46% (65 and older) of episodes.
Refer to Consumer outcomes in mental health care for more information.
Where do I go for more information?
More information on mental health services can be found in Mental health online report.
If you or someone you know needs help please call:
| Term | Definition |
|---|---|
| Admitted care: | A specialised mental health service that provides overnight care in a psychiatric hospital or a specialised mental health unit in an acute hospital. Psychiatric hospitals and specialised mental health units in acute hospitals are establishments devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders. These services are staffed by health professionals with specialist mental health qualifications or training and have as their principal function the treatment and care of patients affected by mental disorder/illness. |
| Admitted patient: | A patient who undergoes a hospital's formal admission process. |
| Ambulatory care: |
A specialised mental health service that provides services to people who are not currently admitted to a mental health admitted or residential service. Services are delivered by health professionals with specialist mental health qualifications or training. Ambulatory mental health services include:
|
| Burden of disease and injury: | A term referring to the quantified impact of a disease or injury on an individual or population, using the disability-adjusted life year (DALY) measure. |
| Hospitalisation: |
Synonymous with admission and separation; that is, an episode of hospital care that starts with the formal admission process and ends with the formal separation process. An episode of care can be completed by the patient’s being discharged, being transferred to another hospital or care facility, or dying, or by a portion of a hospital stay starting or ending in a change of type of care (for example, from acute to rehabilitation). |
| Mental health-related medications: |
Benefit-paid pharmaceuticals and other medications defined in this section as 5 selected medication groups as classified in the Anatomical Therapeutic Chemical (ATC) Classification System (WHO 2022), namely antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A), and psychostimulants, agents used for ADHD and nootropics (code N06B) – prescribed by all medical practitioners (that is, general practitioners (GPs), non‑psychiatrist specialists and psychiatrists). Data include PBS subsidised (above-co-payment) and under-co-payment prescriptions. More information can be found in the Mental health-related prescriptions section of Mental Health Online Report. |
| Restraint: |
The restriction of an individual's freedom of movement by physical or mechanical means. The application of devices (including belts, harnesses, manacles, sheets and straps) on a person's body to restrict his or her movement. This is to prevent the person from harming himself/herself or endangering others or to ensure the provision of essential medical treatment. It does not include the use of furniture (including beds with cot sides and chairs with tables fitted on their arms) that restricts the person's capacity to get off the furniture except where the devices are used solely for the purpose of restraining a person's freedom of movement. The use of a medical or surgical appliance for the proper treatment of physical disorder or injury is not considered mechanical restraint. The application by health care staff of ‘hands-on’ immobilisation or the physical restriction of a person to prevent the person from harming himself/herself or endangering others or to ensure the provision of essential medical treatment. |
| Seclusion: |
The confinement of the consumer at any time of the day or night alone in a room or area from which free exit is prevented. Key elements include that:
The intended purpose of the confinement is not relevant in determining what is or is not seclusion. Seclusion applies even if the consumer agrees or requests the confinement. The awareness of the consumer that they are confined alone and denied exit is not relevant in determining what is or is not seclusion. The structure and dimensions of the area to which the consumer is confined is not relevant in determining what is or is not seclusion. The area may be an open area, for example, a courtyard. Seclusion does not include confinement of consumers to High Dependency sections of gazetted mental health units, unless it meets the definition. |
| Service contact (community mental health care) | The provision of a clinically significant service by a specialised mental health service provider for patient/clients, other than those admitted to psychiatric hospitals or designated psychiatric units in acute care hospitals and those resident in 24‑hour staffed specialised residential mental health services, where the nature of the service would normally warrant a dated entry in the clinical record of the patient/client in question. Any one patient can have one or more service contacts over the relevant financial year period. Service contacts are not restricted to face‑to‑face communication but can include telephone, video link or other forms of direct communication. Service contacts can also be either with the patient or with a third party, such as a carer or family member, and/or other professional or mental health worker, or other service provider. |
| Specialised mental health care facilities |
Specialised facilities that deliver and provide support for mental health care. These can including public and private psychiatric hospitals, psychiatric units or wards in public acute hospitals, Community mental health care services and government-operated and non-government-operated Residential mental health services. More information can be found in Specialised mental health care facilities. |
ABS (Australian Bureau of Statistics) (2007), National Survey of Mental Health and Wellbeing: Summary of Results, ABS Website, accessed 1 June 2023.
ABS (2022) National Study of Mental Health and Wellbeing, ABS, accessed 1 June 2023.
AIHW (Australian Institute of Health and Welfare) (2022a) Australian Burden of Disease Study 2022: Burden of disease in Australia, AIHW website, accessed 1 June 2023.
AIHW (2022b) Mental health: Topic areas summary, AIHW website, accessed 1 June 2023.
RANZCP (Royal Australian and New Zealand College of Psychiatrists) (2021) Position Statement 61: Minimising and, where possible, eliminating the use of seclusion and restraint in people with mental illness, RANZCP website, accessed 1 June 2023.
WHO (World Health Organisation) (2022), ATC: Structure and principles, Oslo: WHO Collaborating Centre for Drug Statistics Methodology, accessed 1 June 2023.
This page was last updated in July 2023