Consumer perspectives of mental health care

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Summary

Key points

  • 29,019 consumer-rated experience of service surveys were collected during 2020–21 in New South Wales, Victoria and Queensland.­
  • An experience of service score is calculated for each survey using the consumer’s responses to 22 survey questions. Using this calculation, a positive experience of service was reported during 2020–21 by:
    • 71% of respondents in New South Wales, 53% in Victoria and 51% in Queensland in admitted care; and
    • 81% of respondents in New South Wales, 75% in Victoria and 82% in Queensland in ambulatory (non-admitted) care.
  • In admitted and ambulatory care, a higher proportion of respondents with Voluntary mental health legal status reported a positive experience of service than respondents with Involuntary legal status.

Three jurisdictions, New South Wales, Victoria and Queensland, have implemented the Your Experience of Service (YES) patient experience survey in their public specialised mental health services and supply data for annual national reporting under the YES National Best Endeavours Data Set.

During 2019–20 and 2020–21, Australians and Australian mental health services have been impacted by the COVID-19 pandemic. Victoria did not conduct the YES survey in 2019–20 and the number of surveys received across all states during 2020–21 is lower than 2018–19 before the pandemic.

During 2020–21, a higher proportion of consumers reported a positive experience of service:

  • in ambulatory or residential mental health care compared to admitted settings (with the exception of consumers aged 65 and older in Victoria), and/or
  • if the person was recorded as receiving care under Voluntary status rather than Involuntary mental health legal status, and/or
  • if the person reported they were not of Aboriginal and/or Torres Strait Islander origin and received ambulatory care.

Generally, during 2020–21, higher proportions of consumers who completed the YES survey had a positive experience of service than not. However, consumers rated their experience of service as Poor in 861 surveys in admitted care (about 4.6%) and 383 surveys in ambulatory care (about 3.9%). YES was designed to help Australian mental health services and consumers work together to build better services. The jurisdictions that have implemented the survey advise they have developed local practices to translate the data received from consumers completing YES to drive quality improvement in their services.

Other states and territories are planning to roll out YES in their specialised mental health services. It is anticipated that YES data will become progressively available from additional jurisdictions in the coming years.

Spotlight data: Do consumers report having a positive experience of Australian mental health care?

Interactive infographic containing a map of Australia highlighting New South Wales, Queensland and Victoria who contributed Your Experience of Service (YES) survey data for 2020–21 and doughnut charts showing the proportion of survey respondents with a positive experience of service in admitted and ambulatory care for each state. There were 29,019 surveys across 87 mental health service organisations. At least 50.7% of consumers in admitted care reported a positive experience of service. At least 74.6% of consumers in ambulatory care reported a positive experience. Refer to Table CP.5.

Notes

  1. An individual consumer may have completed the Your Experience of Service (YES) survey more than once in the reporting period.
  2. The experience of service score is the average of survey questions 1–22 multiplied by 20. A score of 80 and above (out of 100) indicates a positive experience.
  3. In NSW, consumers are offered the YES survey throughout the year, while in Vic and Qld, consumers are offered the YES over a particular time of year. Comparisons between jurisdictions should be made with caution.

Source: Your Experience of Service Survey Database; Table CP.5.

Introduction

Monitoring mental health consumer and carer experiences of service has been a long-term goal of the National Mental Health Strategy (for example, the Department of Health’s National Mental Health Policy 2008). This section presents information about consumer-rated experiences of care in public specialised mental health services using the nationally developed Your Experience of Service (YES) survey.

YES aims to help Australian mental health services and consumers work together to build better services. Currently 3 jurisdictions have implemented YES – New South Wales, Queensland and Victoria – and are contributing to the Your Experience of Service National Best Endeavours Data Set (NBEDS).

The data source section provides more detailed information on the development of the YES survey, participating states and territories, and other aspects of the YES data supply.

Collected surveys

A total of 29,019 YES surveys were collected during 2020–21 (Figure CP.1). New South Wales collected 23,139 surveys, Queensland 3,507 and Victoria 2,373. Compared to the first year of data in 2015–16, the number of returned surveys has increased in all jurisdictions (Figure CP.1.1). Note that in New South Wales consumers are offered the survey at the end of each episode of care, while in Victoria and Queensland consumers are encouraged to complete the survey at a particular time in the year (the data source section provides more detailed information on each state’s methodology). This difference in methodology should be considered when interpreting data from different states. Demographic and other characteristics of consumers who completed surveys are in Figure CP.2.

In admitted care settings, 53.0% of the returned YES surveys were from consumers who received care for a period of 1 day to 2 weeks and 7.8% from consumers who received care for more than 6 months. In residential care, 32.1% were for 1 day to 2 weeks and 25.4% for more than 6 months. This is in contrast to ambulatory care where consumers typically received care for longer periods – in ambulatory care, 8.2% of surveys were from consumers who received care for 1 day to 2 weeks and 50.3% for more than 6 months (Table CP.2).

Figure CP.1: Number of collected Your Experience of Service surveys

Figure CP.1, vertical stacked bar graph showing the number of surveys completed by mental health consumers during 2020–21 for each state, by service setting. In NSW the number of surveys completed is highest in admitted care. In Vic and Qld the number of surveys completed is highest for consumers in ambulatory care. In all states the number of surveys is lowest for consumers in residential care. Refer to Table CP.1.
Figure CP.1.1, line graph showing the number of surveys completed by mental health consumers during 2015–16 to 2020–21 for each state. NSW, Vic and Qld show an increase in the number of completed surveys over time. Refer to Table CP.1. 

Figure CP.1.1 showing the number of surveys over time can be found on the MHSA website.

Notes

  1. An individual consumer may have completed the survey more than once in the reporting period.
  2. In NSW, consumers are offered the YES survey throughout the year, while in Vic and Qld, consumers are offered the YES over a particular time of year. Comparisons between jurisdictions should be made with caution.

Source: Your Experience of Service Survey Database; Table CP.1.

Source data: Consumer perspectives of mental health care tables 2020–21

Figure CP.2: Characteristics of consumers who completed Your Experience of Service surveys, by setting, 2020–21

Figure CP.2: Horizontal bar graph showing the per cent of surveys by consumer characteristics (age group, gender, Indigenous status, mental health legal status) and service setting for 2020–21. Refer to Table CP.3

The interactive figure CP.2 showing other settings can be found on the MHSA website.

Note: 1. An individual consumer may have completed the survey more than once in the reporting period.

Source: Your Experience of Service Survey Database; Table CP.3.

Source data: Consumer perspectives of mental health care tables 2020–21

Consumers-rated experience

Two different experience of service ratings are used in this report.

Consumers’ ratings of care (single item)

Reports consumers’ response to a single question in the YES survey, ‘Overall, how would you rate your experience of care with this service in the last 3 months?’. Consumers can select one of five responses – Poor, Fair, Good, Very-Good or Excellent.

Consumers’ positive experience of service (calculated score)

A nationally agreed score developed to reflect each respondent’s experience across multiple survey questions. It is calculated by averaging the consumer’s responses across 22 survey questions, which is then multiplied by 20 to generate a score out of 100. A score of 80 or higher is used to indicate a positive experience of service.

Consumers' ratings of care (Poor–Fair–Good–Very Good–Excellent on single item)

The YES survey question, ‘Overall, how would you rate your experience of care with this service in the last 3 months?’ provides an overall indication of a respondent’s experience of care.

In all states and service settings, a higher proportion of consumers rated their experience as ‘Excellent’ than any other category (Figure CP.3).

Figure CP.3: Consumer ratings of mental health care, by state and setting

Vertical bar graph showing the per cent of surveys where consumers rated their experience of service as Poor, Fair, Good, Very Good and Excellent in 2020–21 for each state by service setting. In all states and service settings, a higher proportion of consumers rated their experience as ‘Excellent’ than any other category. Refer to Table CP.4.

The interactive figure CP.3 showing other consumer ratings of care in ambulatory care and residential care settings can be found on the MHSA website.

Notes

  1. An individual consumer may have completed the survey more than once in the reporting period.
  2. Response to question, 'Overall, how would you rate your experience of care with this service in the last 3 months?'.

Source: Your Experience of Service Survey Database; Table CP.4.

Source data: Consumer perspectives of mental health care tables 2020–21

Consumers’ experiences of service (Positive using calculated score)

A nationally agreed overall score out of 100 has been developed to reflect each respondent’s ‘experience of service’ across 22 questions in the YES survey (further information on the score methodology can be found in the data source section). A score of 80 or above indicates a positive experience of service.

During 2020–21, a higher proportion of surveys provided responses indicating a positive experience of care than not, in all service settings and jurisdictions (Figure CP.4). By setting, in all three jurisdictions, ambulatory care and residential care had a higher proportion of surveys from consumers who rated their experience positively than admitted care.

Figure CP.4: Consumer surveys indicating a positive experience of a mental health service

Figure CP.4, Interactive bar graph showing the per cent of consumer surveys with an experience of service score of 80 and above, indicating a positive experience, by state and setting, in 2015–16 to 2020–21. Refer to Table CP.5.
Figure CP.4.1, Interactive horizontal bar graph showing the per cent of consumer surveys with an experience of service score of 80 and above, indicating a positive experience of service, by setting and state, and age group, gender, Indigenous status and mental health legal status in 2020–21. Refer to Tables CP.6 and 7.

The interactive figures CP.4 and CP.4.1 showing consumer surveys indicating a positive experience of service by state, setting and group can be found on the MHSA website.

Notes

  1. An experience of service score of 80 and above (out of 100) indicates a positive experience.
  2. The experience of service score is the average of survey questions 1-22 multiplied by 20.
  3. An individual consumer may have completed the survey more than once in the reporting period.

Source: Your Experience of Service Survey Database; Figure CP.4 - Table CP.5, Figure CP.4.1 - Tables CP.6 and 7.

Source data: Consumer perspectives of mental health care tables 2020–21

Key concepts

Key concept Description
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.
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:

  • community-based crisis assessment and treatment teams;
  • day programs;
  • mental health outpatient clinics provided by either hospital or community-based services;
  • child and adolescent outpatient and community teams;
  • social and living skills programs;
  • psychogeriatric assessment services;
  • hospital-based consultation-liaison and in-reach services to admitted patients in non-psychiatric and hospital emergency settings;
  • ambulatory-equivalent same day separations;
  • home based treatment services; and
  • hospital based outreach services

Whether a person was provided care under relevant state or territory mental health legislation compulsory treatment provisions.

The state and territory mental health acts and regulations provide the legislative guidance that safeguards the rights and governs the care of patients with mental illness in admitted patient care, residential care and community-based services. The legislation varies between the state and territory jurisdictions but all contain provisions for the assessment, admission and treatment of patients on an involuntary basis.

A person with involuntary status received care under compulsory treatment provisions.

A person with voluntary status received care that was not under compulsory treatment provisions.
Residential care

A service that is considered by the state, territory or Australian Government funding authorities as a service that:

  • has the workforce capacity to provide specialised mental health services; and
  • employs suitably trained mental health staff to provide rehabilitation, treatment or extended care on-site:
    • to consumers residing on an overnight basis;
    • in a domestic-like environment; and
  • encourages the consumer to take responsibility for their daily living activities.

These services include those that employ mental health trained staff on-site 24 hours per day and other services with less intensive staffing (but the trained staff must be on site for a minimum of 6 hours a day and at least 50 hours per week).

Suitably trained residential mental health care staff may include:

  • individuals with Vocational Education and Training (VET) qualifications in community services, mental health or disability sectors;
  • individuals with tertiary qualifications in medicine, social work, psychology, occupational therapy, counselling, nursing or social sciences; and
  • individuals with experience in mental health or disability relevant to providing mental health consumers with appropriate services.
Specialised mental health services

Specialised mental health services are those with a primary function to provide treatment, rehabilitation or community support targeted towards people with a mental disorder or psychiatric disability. These activities are delivered from a service or facility that is readily identifiable as both ‘specialised’ and ‘serving a mental health care function’.

A service is not defined as a specialised mental health service solely because its clients include people affected by a mental disorder or psychiatric disability.

The definition excludes specialist drug and alcohol services and services for people with intellectual disabilities, except where they are specifically established to assist people affected by a mental disorder who also have drug and alcohol related disorders or intellectual disability.

The services can be sub-units of hospitals that are not, themselves, specialised mental health establishments (for example designated psychiatric units and wards, outpatient clinics etc).
Your Experience of Service National Best Endeavours Data Set (YES NBEDS)

The YES NBEDS is Data Set Specification that describes the YES survey questions and defines coding for responses. The scope of YES NBEDS is state and territory public sector specialised mental health services. Specific information for each data element can be found in the YES NBEDS entry on the METEOR website.

 

This section was last updated in August 2022.

Data coverage is 2015–16 to 2020–21 for New South Wales, Queensland and Victoria; Victoria did not conduct the survey during 2019–20 due to the COVID-19 pandemic. It is anticipated that data will become available from additional jurisdictions for future updates.