Specialised mental health care facilities
162 public hospitals and 70 private hospitals
provided specialised mental health services during 2020-21.
7,100 specialised mental health public hospital beds
were available in 2020–21
were employed by community mental health care services in 2020-21.
Specialised mental health care facilities are a key component in delivering mental health care in Australia. Specialised mental health care is delivered in and by a range of facilities 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. The information presented in this section is drawn primarily from the National Mental Health Establishments Database. More detail about these and the other data used in this section can be found in the data source section.
Overview of specialised mental health care facilities across Australian states and territories, 2011–12 to 2020–21
An overview of specialised mental health care facilities nationally and for states and territoriesfrom 2011–12 to 2020-21, with the option to display data from 1993–94 to 2020–21.
Note: Data not published will appear as '0'. Refer to data tables for further details.
Source: Specialised mental health care facilities tables
What mental health facilities are available for Aboriginal and Torres Strait Islander people?
Aboriginal and Torres Strait Islander people may access a range of culturally appropriate mental health services provided by Australian, state and territory governments.
For example, the Australian Government funds health organisations to provide social and emotional wellbeing/mental health/counselling (SEWB) services for Indigenous Australians (AIHW 2022). SEWB services provide a range of support services including counselling, casework, family tracing and reunion support and other wellbeing activities for individuals, families, and communities.
In 2020–21, about 550 SEWB staff were located across Australia, providing approximately 269,000 client contacts (AIHW 2022). For more information on the organisation profile, staffing and types of services provided by SEWB services, refer to the report Aboriginal and Torres Strait Islander specific primary health care: results from the nKPI and OSR collections (2020–21).
During 2020–21, there were 175 Specialised mental health service organisations across Australia responsible for the administration of the 1,790 state and territory specialised mental health facilities (excluding private hospitals). For most states and territories, a specialised mental health service organisation is equivalent to the area/district mental health service. These organisations may consist of one or more specialised mental health service units, sometimes based in different locations.
More than three-quarters (79% or 139) of these organisations provided community services. Two-thirds (66% or 115) provided public hospital services, and almost half (45% or 78) provided residential services.
Almost two-thirds (63% or 111) of these organisations provided 2 or more types of services. Among these, almost all (98% or 109) paired public hospital services and community services. This group accounted for almost all beds and patient days (98% and 97% respectively) provided by public hospital services and almost all (94%) community service contacts.
In 2020–21, over half (57% or 100) of these organisations employed Consumer workers, and more than 1 in 4 (29% or 50) employed Carer workers. New South Wales and South Australia had the highest proportion of organisations employing Consumer workers (88% and 81% respectively). South Australia and Queensland had the highest proportion of organisations employing Carer workers (both 67%).
Between 2016–17 and 2020–21, the rate of full-time equivalent (FTE) Consumer workers per 10,000 mental health care provider FTE staff increased by an annual average of 23%. For Carer workers over this period the annual average increase was 21%. Time series comparisons with this workforce should be approached with caution (more information can be found in the data source section
Specialised mental health organisations report which consumer committee representation arrangements are in place to promote the inclusion of mental health consumers in the planning, delivery and evaluation of the service. These arrangements are reported across 4 levels: Level 1 represents the most formal consumer committee representation arrangements and Level 4 no formal consumer advisory arrangements. The data source section provides full descriptions of each level.
In 2020–21, 3 in 5 (59% or 104) organisations reported a formal position on their management committee or specific consumer advisory committee.
Between 2016–17 and 2020–21, the proportion of organisations with Level 1 arrangements decreased from 64% to 59%, while the proportion of Level 4 representation increased from 19% to 25% (Figure FAC.1).
Figure FAC.1: Specialised mental health organisations, by level of consumer committee representation, 2011–12 to 2020–21
A stacked area chart showing the level of consumer committee representation arrangements in mental health organisations from 2011–12 to 2020–21, with the option to display data from 1993–94 to 2020–21. Over the past 10 years, Level 1 consumer representation has consistently been the most common arrangement, while Level 2 consumer representation has consistently been the least common. Refer to Table FAC.8.
Level 1 Formal consumer position(s) exist on the organisation’s management committee; or specific consumer advisory committee(s) exist to advise on all mental health services managed.
Level 2 Specific consumer advisory committee(s) exist to advise on some mental health services managed.
Level 3 Consumers participate on an advisory committee representing a wide range of interests.
Level 4 No consumer representation on any advisory committee; meetings with senior representatives encouraged.
Source: Specialised mental health care facilities tables FAC.8
Services provided by specialised mental health organisations are measured against the National Standards for Mental Health Services (the National Standards). There are 8 levels available to describe the degree to which a specialised mental health service organisation meets the National Standards, from Level 1 (a service unit has met all national standards) through to Level 8 (national standards do not apply). Reporting levels for National Standards can be found in the data source section, which provides full descriptions of all 8 levels and how they are grouped into 4 levels for reporting purposes.
In 2020–21, more than 9 in 10 (92%) service units reviewed by an external accreditation agency, such as the Australian Council on Healthcare Standards (ACHS) or the Quality Improvement Council (QIC), met the National Standards (Level 1). South Australia, Tasmania, Western Australia and Queensland reported over 99% of units meet Level 1. The Northern Territory reported that all units were assessed under service accreditation standards that do not include certification for the National Standards, therefore it has reported that 100% of units meet Level 4. From 2017–18, services in the Australian Capital Territory have been accredited against the National Safety and Quality Health Services (NSQHS) Standards, which meet some but not all of the National Standards.
During 2020–21, there were approximately 13,100 specialised mental health beds available nationally. Of these about 7,100 beds were in public hospital services, 3,580 in private hospitals, and 2,420 in residential mental health care services (Figure FAC.2).
Figure FAC.2: How are specialised mental health beds distributed in 2020–21?
The distribution of specialised mental health beds in 2020–21. The table shows that the majority of beds were provided in hospitals, while residential beds accounted for approximately 1 in 5 beds. Public hospitals provided around twice the number of beds than private hospitals and most public hospital beds were for acute care. The majority of residential mental health care services beds were provided by government-operated services. Most of the residential beds in government-operated services were provided in 24-hour staffed residential services, whereas in non-government operated services, more beds were provided in non-24 hour staffed services.
Source: Specialised mental health care facilities tables
Public sector specialised mental health hospital beds
In 2020–21, of the approximately 7,100 public sector specialised hospital beds available in Australia, more than three quarters (78% or about 5,520) were in specialised psychiatric units or wards within public acute hospitals, with the remainder in public psychiatric hospitals (about 1,580).
New South Wales had the highest rate of beds per 100,000 population in 2020–21 (33), while the Northern Territory had the lowest (17), compared to the national rate of 28.
During 2020–21, most public sector specialised mental health hospital beds (5,130 or 72%) were in General services, 890 (13%) were in Older person services, 680 (10%) were in Forensic services and 320 (5%) were in Child and adolescent services. A small number of beds were in Youth services (1% or 78), a service category introduced in 2011–12.
The proportion of specialised hospital beds for each service category varied across states and territories, reflecting differing service profiles across jurisdictions. Most beds were in services classified as General, accounting for at least two-thirds of beds in each jurisdiction.
New South Wales had the highest rate of specialised beds for General services with 41 per 100,000 population (compared to a national average of 33). Queensland had the highest rate of beds for Child and adolescent services (7, national average 6) and the Northern Territory had the highest rate of beds for Youth services (17, national average 3). Western Australia had the highest rate of beds for Older person services (36, national average 21). The Australian Capital Territory had the highest rate of beds for Forensic services (6, national average 3) (Figure FAC.3).
Figure FAC.3: Public sector specialised mental health hospital beds, by target population, states and territories, 2020–21
Stacked bar chart showing the proportion of public sector specialised mental health hospital beds by target population and states and territories in 2020–21. Target Populations are: General, Child and adolescent, Youth, Older person and Forensic. Beds in General services had the highest rate per 100,000 across all jurisdictions, except for Western Australia and the Australian Capital Territory, in which the highest rates were for Older person services. Refer to Table FAC.14.
Source: Specialised mental health care facilities tables FAC.14 & FAC.23
In 2020–21, there were about 2,420 residential mental health service beds available nationally. These can be characterised by staffing level, target population and the service operator, reflecting the service profile mix implemented in each state or territory.
Over two-thirds of residential beds (1,680 or 69%) were in government-operated services.
More than 4 in 5 (82% or 1,990) residential beds were operated with mental health trained staff working in active shifts for 24 hours a day, with most of these beds in government-operated services (84% or 1,670). By contrast, non-24-hour staffed residential beds were predominantly provided by the non-government sector.
More than two-thirds (68% or 1,650) of all residential beds were in General services with the majority of these (80% or 1,330) in 24-hour staffed facilities.
In the Australian Capital Territory, from 2015–16 to 2016–17 there was a decline in the reported number of non-24 hour staffed residential beds, from 45 to 5 beds. These beds are still operational but as they are funded under the National Disability Insurance Scheme (NDIS), they are now out of scope for reporting to the Mental Health Establishments (MHE) NMDS. Since the implementation of the NDIS there has been a decrease in the number of non-24-hour staffed residential specialised beds reported to the MHE NMDS.
In 2020–21, there were 9.5 residential beds per 100,000 population nationally. Among jurisdictions, Tasmania (26) had the highest rate and New South Wales (0.4) the lowest (Figure FAC.4). New South Wales and Western Australia were the only jurisdictions where non-24-hour staffed residential services provided more beds than 24-hour staffed services.
Victoria (47) had the highest rate of residential beds in Older persons 24-hour staffed care services. Tasmania had the highest rate of residential beds in General services for both 24-hour staffed care (21) and non-24-hour staffed care (12). New South Wales (0.5) was the only state or territory that reported residential service beds for Child and adolescent services in 2020–21. Four jurisdictions reported specialised Youth services, with Victoria reporting 20 beds per 100,000 population; Queensland, 6.6; Western Australia, 5.5; and the Australian Capital Territory, 19.
Three quarters (75% or 5,330) of public sector specialised hospital beds across Australia were in Acute services during 2020–21 (Figure FAC.4).
The proportion of Acute beds differed across target population groups. Most General beds (76%), Child and adolescent beds (86%), Youth beds (100%), and Older person beds (84%) were in Acute services in 2020–21, compared with less than half of Forensic beds (48%).
Figure FAC.4: Residential mental health service beds per 100,000 population, by hours staffed and target population, states and territories, 2011–12 to 2020– 21
A line graph of residential mental health service beds per 100,000 population by hours staffed and target population in states and territories from 2011–12 to 2020–21, with the option to display data from 1993–94 to 2020–21. Between 2011–12 and 2020–21, the rate of 24-hour staffed beds for the general population has trended up, from 6.4 per 100,000 population to 8.4. Over the same period, the rate of non-24-hour staffed beds has trended down, from 5.0 to 2.1. Refer to Table FAC.19.
Source: Specialised mental health care facilities tables FAC.19
24-hour staffed public sector care
Mental health services with staff employed in active shifts for 24 hours a day are provided through either public sector specialised hospital services (inpatient care) or 24-hour staffed residential care services. Comparisons between states and territories are possible when the data for these different types of services are combined.
In 2020–21, the national average for 24-hour staffed public sector beds was 35 beds per 100,000 population. Victoria had the highest rate (41) and the Northern Territory (31) had the lowest rate (Figure FAC.5).
Acute hospital services accounted for the highest rate of beds across most states and territories, although in Tasmania the rates of beds for Acute services and 24-hour staffed residential services were the same (18.7 and 18.6 respectively).
Figure FAC.5: Public sector specialised mental health hospital beds per 100,000 population, by program type, and 24-hour-staffed residential mental health service beds per 100,000 population, states and territories, 2020–21
Stacked vertical bar chart showing public sector specialised mental health hospital beds per 100,000 population, by program type, and 24-hour-staffed residential mental health service beds per 100,000 population, states and territories, 2020–21: New South Wales (33.4), Victoria (41.3), Queensland (31.9), Western Australia (34.8), South Australia (34.9), Tasmania (37.3), Australian Capital Territory (33.2), Northern Territory (30.5), national rate (35.4). Across all states and territories, the highest number of beds per 100,000 were provided by Acute hospital services: New South Wales (22.0), Victoria (19.7), Queensland (17.0), Western Australia (26.5), South Australia (22.0), Australian Capital Territory (23.0) and Northern Territory (17.3). In Tasmania (18.7) the rate of beds per 100,000 in Acute services was almost the same as the rate for beds in 24-hour staffed residential services (18.6). Refer to Table FAC.23.
Source: Specialised mental health care facilities tables FAC.23
Private hospital specialised mental health beds
There was an increase in the number of specialised residential service beds from about 2,280 in 2016–17 to about 2,420 in 2020–21. Over this period, the rate of residential mental health service beds per 100,000 population ranged between 9.4 and 10.3. In 2020-21, the highest rates were in Tasmania (26) and Victoria (21), while New South Wales had the lowest (0.4).
There was a decrease in the number of public psychiatric hospital beds in the past 5 years, from about 1,680 beds in 2016–17 to about 1,580 beds in 2020–21. Over this period there was an increase in the number of beds in specialised psychiatric units or wards in public acute hospitals, from about 5,500 in 2016–17 to about 5,520 in 2020–21. Time series comparisons should be approached with caution.
The number of public sector specialised hospital and residential service beds has changed little in the past 5 years, increasing from about 9,460 beds in 2016 –17 to about 9,520 beds in 2020–21. Over the same period, the combined rate of hospital and residential beds per 100,000 population has declined from 36.3 to 35.4. The combined rate of public hospital and residential beds when reporting began in 1992–93 was 50.
There were about 3,580 available beds (14 per 100,000 population) in private psychiatric hospitals in 2020–21, including specialised units or wards. More information on private hospital specialised mental health beds, can be found in the report Private Hospital-based Psychiatric Services 1 July 2020 to 30 June 2021.
In addition to the services described above, jurisdictions also provide supported housing places for people diagnosed with a mental illness. Nationally, 4,420 supported housing places were available in 2020–21. Western Australia (51 per 100,000 population) had the highest rate of supported housing places, compared with the national average of 17. However, caution should be exercised when comparing rates across jurisdictions as not all jurisdictional mental health housing support schemes are in scope for the Mental Health Establishment NMDS. The data source section provides further information.
Patient days are those days of admitted patient care provided in public psychiatric hospitals, in specialised psychiatric units or wards in public acute hospitals, in residential services, and in private hospitals. The total number of patient days is reported by service units.
During 2020–21, private hospital services provided about 1.2 million patient days, equating to 48 days per 1,000 population. However, in contrast with public sector services, this figure also includes same-day separations.
During 2020–21, residential services provided more than 710,000 patient days. Over 4 in 5 (82%) were for residents of 24-hour staffed services. Tasmania (103) had the highest rate per 1,000 population in General services, while New South Wales (2) had the lowest. The national rate in General services was 31.
Around 2.3 million patient days were provided by public hospital services during 2020–21. Over three-quarters (78%) of these were in specialised psychiatric units or wards in public acute hospitals, reflecting the number of available beds for this service type.
Across public sector hospital services in 2020–21, New South Wales (105) had the highest rate per 1,000 population, while Tasmania (60) had the lowest. The national rate was 90.
State and territory specialised services include public psychiatric hospitals, psychiatric units or wards in public acute hospitals, community services and government and non‑government‑operated residential services.
In 2020–21, there were 143 FTE staff per 100,000 population nationally employed in specialised services (Figure FAC.6).
The Northern Territory (219) had the highest rate of FTE staff per 100,000 population, while Victoria (136) had the lowest. Nurses were the largest FTE staff category across all jurisdictions.
In 2020–21, of the approximately 36,700 FTE staff of state and territory specialised services, about half were Nurses (51% or about 18,700 FTE) of which most were Registered nurses (16,100 FTE). Diagnostic and allied health professionals were the second largest group (20%), comprising mostly Social workers (2,670 FTE) and Psychologists (2,010 FTE). Salaried medical officers made up 11% of FTE staff, with similar numbers of consultant psychiatrists and psychiatrists (1,750 FTE) and Psychiatry registrars and trainees (1,940 FTE).
Figure FAC.6: Full-time-equivalent staff per 100,000 population by staffing category, states and territories, 2011–12 to 2020–21
Line chart showing full-time-equivalent staff per 100,000 population by staffing category and jurisdictions from 2011–12 to 2020–21, with the option to display data from 1993–94 to 2020–21. Staffing categories are: Salaried medical officers, Nurses, Diagnostic and allied health professionals, Other personal care, Consumer workers, Carer workers and Other staff. Nurses made up the majority of full-time-equivalent staff across all jurisdictions. Refer to Table FAC.37.
Source: Specialised mental health care facilities tables FAC.37
The population rate of FTE staff employed in specialised services increased between 2016–17 and 2020–21 by an average annual change of 1.7%. The rate of FTE consumer workers increased from 0.5 to 1.3 over this period. The rate of FTE staff per 100,000 population employed in specialised mental health care services has increased between 2015–16 and 2019–20 at an average annual increase of 1.2%. The labour force category Other staff decreased by an annual 1.6% over this time period. The rate of FTE consumer workers increased from 0.5 to 0.8 over this period.
State and territory specialised mental health care service units
Staff employed by state and territory specialised mental health care services can also be described by the service setting where they are employed.
More than two-fifths (44% or about 16,200 FTE) of state and territory staff were employed in public hospital specialised services during 2020–21. Community services employed the next largest number of FTE staff (40% or about 14,500 FTE). While the rate of FTE staff per 100,000 population within organisational overhead settings decreased from 14 to 13 between 2016–17 and 2020–21, over the same period, the rate increased for public hospital services (from 60 to 63), residential services (from 8.6 to 10) and community services (from 51 to 57).
Health care providers include the staffing categories of Salaried medical officers, Nurses, Diagnostic and allied health professionals, Consumer and carer workers and Other personal care staff. These categories can be described at the overall organisational level, by service setting and by target population. In 2020–21, public hospital services employed 58 FTE health care providers per 100,000 population (Figure FAC.7). Community services employed 51 FTE health care providers in 2020–21 and residential services employed 9.3.
Between 1992–93, when reporting began, and 2020–21, the FTE rate was consistently highest for hospital admitted patient service settings, ranging between 45 and 58 (in 2000–01 and 2020–21 respectively). The rate was consistently second highest for community mental health care service settings, which increased from 19 in 1992–93 to 51 in 2020–21. The rate for residential service settings increased from 4 to 9 between 1992–93 and 2020–21, with a low of 3 in 1993–94. The organisational overhead setting has been reported since 2012–13, with a rate ranging between 4 and 6 during the past 9 reporting periods.
Since the start of reporting in 1993–1994 , the population rate of FTE staff employed by hospital admitted patient services has ranged between 58 and 77 FTE per 100,000 population. Between 2016–17 and 2020–21, this rate has increased from 60 to 63.
The rate of FTE staff employed by community services increased every year from 1993–94 to 2011–12 (from 24 to 58 FTE) after which it levelled off in the low 50s. Between 2016–17 and 2020–21, the rate has again increased from 51 to 57.
The rate of FTE staff employed by residential services has been broadly stable over the past 21 reporting periods (typically between just below 9 and 10 FTE per 100,000 population). Organisational overhead service settings have been reported as a service setting since 2012–13, with the rate ranging between 10 and 14 FTE.
Figure FAC.7: Full-time-equivalent health care providers per 100,000 population, by service setting, state and territory specialised mental health service units, 1992–93 to 2020–21
Line graph showing full-time-equivalent health care providers per 100,000 population, state and territory specialised mental health service units, by service setting from1992–93 to 2020–21, with the option to display data from 2011–12 to 2020–21. Over the past 30 years, the rate was consistently highest for hospital admitted patient service settings, ranging between 45.1 (in 2000–01) and 58.0 (in 2020–21). The rate was consistently second highest for community mental health care service settings, which increased from 19.1 in 1993–1994 to 50.8 in 2020–21. The rate for residential mental health care service settings increased from 4.0 in 1993–94 to 9.3 in 2020–21. The organisational overhead setting has been reported since 2012–13, with a rate ranging from 3.7 in 2012–13 to 5.4 in 2020–21. Refer to Table FAC.43.
Source: Specialised mental health care facilities tables FAC.43
Collection of data for the Mental Health Establishments (MHE) NMDS began on 1 July 2005, replacing the Community Mental Health Establishments NMDS and the National Survey of Mental Health Services. The development of the MHE NMDS was to expand on the Community Mental Health Establishments NMDS and replicate the data previously collected by the National Survey of Mental Health Services. The National Mental Health Establishments Database is compiled as specified by the MHE NMDS.
The scope of the MHE NMDS is all specialised mental health services managed or funded, partially or fully, by state or territory health authorities. Specialised mental health services are those with the primary function of providing treatment, rehabilitation or community health 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.
The MHE NMDS data are provided at several levels: state, regional, organisational and individual mental health service unit. The data elements at each level in the NMDS collect information appropriate to that level. The state, regional and organisational levels include data elements for revenue, grants to non-government organisations and indirect expenditure. The organisational level also includes data elements for salary and non-salary expenditure, numbers of full-time-equivalent staff and consumer and carer worker participation arrangements. The individual mental health service unit level comprises data elements that describe the function of the unit. Where applicable, these include target population, program type, number of beds, number of accrued patient days, number of separations, and number of service contacts and episodes of residential care. In addition, the service unit level also includes salary and non-salary expenditure and depreciation.
Data Quality Statements for National Minimum Data Sets (NMDSs) are published annually on the Metadata Online Registry (METEOR). Statements provide information on the institutional environment, timelines, accessibility, interpretability, relevance, accuracy, and coherence.
Data presented in this publication are the most current data for all years presented. The validation process assesses the data for consistency in the current collection and across historical data. The validation process applies a range of rules to the data to test for potential issues. Jurisdictional representatives respond to each issue before the data are accepted as the most reliable current data collection. This process may highlight issues with historical data. In such cases, historical data may be adjusted to ensure data are more consistent. Therefore, comparisons made to previous versions of Mental health services in Australia publications should be approached with caution.
Mental health consumer and carer workforce data
Consumer worker and carer worker FTE is relatively small, and therefore small changes in these FTE may have a relatively large percentage impact on the rates of change. Additionally, the definition used to describe this component of the workforce changed for the 2010–11 collection to better capture a variety of contemporary roles. Caution is therefore required when interpreting time series data for this workforce. More information can be found in the key concepts.
Consumer committee representation arrangements
Specialised mental health organisations report the extent to which consumer participation arrangements are in place to promote the inclusion of mental health consumers in the planning, delivery, and evaluation of the service. Organisations report their consumer participation arrangements at various levels, as detailed below.
Formal position(s) for consumers exist on the organisation’s management committee for the appointment of person(s) to represent the interests of consumers. Alternatively, specific consumer advisory committee(s) exists to advise on all relevant mental health services managed by the organisation.
Specific consumer advisory committee(s) exists to advise on some but not all relevant mental health services managed by the organisation.
Consumers participate on a broadly based advisory committee that includes a mixture of organisations and groups representing a wide range of interests.
Consumers are not represented on any advisory committee but are encouraged to meet with senior representatives of the organisation as required. Alternatively, no specific arrangements exist for consumer participation in planning and evaluation of services.
There are 8 levels used to describe the extent to which a service unit has implemented the National Standards, as shown in the table below.
The service unit had been reviewed by an external accreditation agency and was judged to have met the National standards as determined by the accrediting agency.
The service unit had been reviewed by an external accrediting agency and was judged to have met some but not all of the National standards.
The service unit was in the process of being reviewed by an external accrediting agency but the outcomes were not known.
The service unit was booked for review by an external accrediting agency and was engaged in self‑assessment preparation prior to the formal external review.
The service unit was engaged in self‑assessment in relation to the National standards but did not have a contractual arrangement with an external accrediting agency for review.
The service unit had not commenced the preparations for review by an external accrediting agency but this was intended to be undertaken in the future.
It had not been resolved whether the service unit would undertake review by an external accrediting agency under the National standards.
The National standards are not applicable to this service unit.
Source: National Standards for Mental Health Services status (see METEOR ID: 573549).
Reporting levels for national standards
To match definitions in the National Key Performance Indicator set for Mental Health Services, the data presented are restricted to 4 levels. Level 1 represents code 1, Level 2 represents code 2, Level 3 represents codes 3 and 4 and Level 4 represents codes 5–7. Code 8 is excluded as the standards do not apply to these units.
To accurately reflect the proportion of mental health services meeting the various National Standards levels, the expenditure reported for each service unit is used to calculate the proportion of services which meets the National Standards. This ensures the relative size of a service unit is accounted for when calculating the proportion of services meeting National Standards. It is important to note that the accreditation process is cyclical in nature and so state and territory results may vary from year to year.
The National Standards for Mental Health Services were revised in 2010 (DoH 2010). In addition to these mental health-specific national standards, other national standards have been published and implemented against which mental health services may also be measured. Work is ongoing to improve the method for reporting the standards against which a service is measured.
New South Wales CADE and T-BASIS services
All New South Wales Confused and Disturbed Elderly (CADE) 24-hour staffed residential mental health care services were reclassified as specialised mental health non-acute admitted patient hospital services, termed Transitional Behavioural Assessment and Intervention Service (T-BASIS), from 1 July 2007. All data relating to these services have been re-classified from 2007–08 onwards, including number of services, number of beds, staffing and expenditure. Comparison of data over time should therefore be approached with caution.
New South Wales Mental Health Community Living Programs
New South Wales has been developing the NSW Housing Accommodation Support Initiative (HASI) since it was established in 2002. This model of care is a partnership program between NSW Ministry of Health, Housing NSW and the non-government organisation (NGO) sector that provides housing linked to clinical and psychosocial rehabilitation services for people with a range of levels of psychiatric disability.
In 2016, Community Living Supports (CLS) commenced to support more people with severe mental illness to access the same type of support provided in HASI.
From 2017–18 New South Wales supported housing places reflect changes resulting from the conclusion of the Commonwealth National Partnership Agreement (NPA) on Mental Health Services. The NSW Government continued funding until Dec 2017 to allow for transition to alternative support arrangements (including the NDIS) for up to 200 people in NPA funded supported housing places.
Both HASI and CLS are reported as Specialised mental health service—supported mental health housing places (METEOR identifier 390929). These programs are out of scope as Residential mental health care services (METEOR identifier 373049). More information about the NSW HASI program can be accessed from the above hyperlink.
Public sector specialised mental health beds
In 2017–18, Queensland reported specialised residential mental health service beds to the Mental Health Establishments collection for the first time due to the reclassification of some public sector mental health hospital beds.
Organisational overhead setting
In 2012–13, the organisational overhead setting was introduced for greater national consistency in reporting and greater clarity about staff delivering care to patients. The organisational overhead setting consists of the components of specialised mental health service organisations not directly involved in the delivery of patient care services in the admitted patient, residential or community mental health care service settings, or in the operations of those settings. The definition does not imply that these roles do not have an impact on service delivery. For example, a chief operating officer not directly providing patient care, nor involved in the operation of services in a specific service setting, would be reported in the organisational overhead setting. The reporting methodology for the new organisational overhead setting is taking time for states and territories to implement (see Table FAC.39 for detailed time series data).
Calculations of rates for target populations are based on age-specific populations as defined by the MHE NMDS metadata and outlined below.
- General services: persons aged 18–64
- Child and adolescent services: persons aged 0–17
- Youth services: persons aged 16–24
- Older persons: persons aged 65 and over
- Forensic services: persons aged 18 and over
Crude rates were calculated using the Australian Bureau of Statistics estimated resident population (ERP) at the midpoint of the data range (for example, rates for 2018–19 data were calculated using ERP at 31 December 2018). Historical rates have been recalculated using revised ERPs based on the 2011 Census of Population and Housing, as detailed in the online technical information.
Private hospital specialised mental health services staffing
Data for staffing provided in private hospital specialised mental health services are no longer available. These data were previously provided by the Australian Bureau of Statistics through its Private Hospitals Establishment Collection (PHEC), but this survey was discontinued in 2016–17.
Private Health Establishments Collection
From 1992–93 to 2016–17 (excluding 2007–08) the ABS conducted a census of all private hospitals licensed by state and territory health authorities and all freestanding day hospitals facilities approved by the Australian Government Department of Health and Aged Care. As part of that census, data on the staffing, finances and activity of these establishments were collected and compiled in the PHEC. Additional information on the PHEC can be obtained from the ABS publication Private hospitals, Australia (ABS 2018).The data definitions used in the PHEC are largely based on definitions in the National health data dictionary (NHDD) published on the AIHW’s Metadata Online Registry (METEOR) website (AIHW 2015). The ABS defines private psychiatric hospitals as those licensed or approved by a state or territory health authority and which cater primarily for admitted patients with psychiatric, mental or behavioural disorders (ABS 2018). This is further defined as those hospitals providing 50% or more of the total patient days for psychiatric patients. This definition can be extended to include specialised units or wards in private hospitals, consistent with the approach in the public sector. For further technical information, see the Private psychiatric hospital data section of the National mental health report 2013 (DoH 2013).
The last data were collected for the 2016–17 period. Increases in psychiatric beds were the result of improvements in methodology to apportion the data between psychiatric and alcohol/drug treatment wards, new establishments reporting for the first time, and a general increase in psychiatric beds in establishments that have reported psychiatric units in the past. Caution is required when comparing data for 2010–11 to other years as the survey was altered such that psychiatric units could no longer be separately identified from alcohol/drug treatment units. Therefore, the data for beds, patient days, separations and staffing were estimates based on reported 2010–11 data and trends observed in previous years. Data from the Private Mental Health collection suggest that these data may be underestimates (PMHA 2013).
Private Psychiatric Hospitals Data Reporting and Analysis Service
The Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service (PPHDRAS), previously known as the Private Mental Health Alliance Centralised Data Management Service (PMHA CDMS), was launched in Australia in 2001 to support private hospitals with psychiatric beds to routinely collect and report on a nationally agreed suite of clinical measures and related data for the purposes of monitoring, evaluating and improving the quality of and effectiveness of care. The PPHDRAS works closely with private hospitals, health insurers and other funders (e.g., Department of Veterans’ Affairs) to provide a detailed quarterly statistical reporting service on participating hospitals’ service provision and patient outcomes.
The PPHDRAS fulfils two main objectives. Firstly, it assists participating private hospitals with implementation of their National Model for the Collection and Analysis of a Minimum Data Set with Outcome Measures. Secondly, the PPHDRAS provides hospitals and private health funds with a data management service that routinely prepares and distributes standard reports to assist them in the monitoring and evaluation of health care quality. The PPHDRAS also maintains training resources for hospitals and a database application, which enables hospitals to submit de-identified data to the PPHDRAS. The PPHDRAS produces an annual statistical report. In 2020-21, the PPHDRAS accounted for 98% of all private psychiatric beds in Australia (APHA 2022)
From 2017–18, all private hospital data are sourced from the PPHDRAS. Data on expenditure and Staffing (FTE) are not collected in the PPHDRAS.
|Beds||The number of available specialised mental health beds refers to the average number of beds that are immediately available for use by an admitted patient within the mental health facility over the financial year, estimated using monthly figures (METEOR identifier 616014). Data prior to 2005–06 were sourced from the National Survey of Mental Health Services, which reported the total number of beds available as at 30 June. Comparison of historical data should therefore be approached with caution.|
|Community mental health care services||Community mental health care services include hospital outpatient clinics and non‑hospital community mental health care services, such as crisis or mobile assessment and treatment services, day programs, outreach services, and consultation/liaison services.|
|Consumer committee representation arrangements||Specialised mental health organisations report the level of consumer committee representation arrangements. To be regarded as having a formal position on a management or advisory committee, the consumer representative needs to be a voting member (METEOR identifier288855). This is independent to the employment of consumer and carer consultants. The data source section provides information on the levels available.|
|Government-operated residential mental health services||
Government‑operated residential mental health services are specialised Residential mental health care services that:
|Health care providers||
Health care providers refers to the following staffing categories: salaried medical officers, nurses, diagnostic and allied health professionals, other personal care staff and mental health consumer and carer workers.
|Mental health carer worker||Mental health carer workers are employed (or engaged via contract) on a part-time or full-time basis specifically for their expertise developed from their experience as a mental health carer (METEOR identifier 717103). Mental health carer workers include the job titles of, but not limited to, carer consultants, peer support workers, carer support workers, carer representatives and carer advocates. Roles that mental health carer workers may perform include, but are not limited to, mental health policy development, advocacy roles and carer support roles.|
|Mental health consumer worker||Mental health consumer workers are employed (or engaged through contracts) on a part-time or full-time basis specifically due to the expertise developed from their lived experience of mental illness (METEOR identifier 450727). Mental health consumer workers include the job titles of, but not limited to, consumer consultants, peer support workers, peer specialists, consumer companions, consumer representatives, consumer project officers and recovery support workers. Roles that mental health consumer workers may perform include, but are not limited to, participation in mental health service planning, mental health service evaluation and peer support roles.|
|National standards for mental health services||
The National standards for mental health services were developed under the First National Mental Health Plan and are applicable to individual service units. There are 8 levels available to describe a service unit's status (METEOR identifier 722190). The data source section provides information for the full description of all 8 levels and information relating to the revised 2010 national standards. For reporting purposes, the data are collated into the following 4 levels:
|Non-government-operated residential mental health services||Non‑government‑operated residential mental health services are specialised Residential mental health care services which meet the same criteria as government‑operated Residential mental health care services. These services, while partially or fully funded by governments, are operated by non‑government agencies. Expenditure reported as non-government operated Residential mental health care services includes the total operating costs for the residential service, not the total operating costs of the non-government organisation as an entity. Expenditure reported as Grants to non-government organisations includes grants made by state and territory government departments to non-government organisations specifically for mental health-related programs and initiatives and are reported separately to expenditure reported for non-government-operated Residential mental health care services.|
|Patient days||Patient days are days of admitted patient care provided to admitted patients in public psychiatric hospitals or specialised psychiatric units or wards in public acute hospitals and in Residential mental health care services. The total number of patient days is reported by specialised mental health service units. For consistency in data reporting, the following patient day data collection guidelines apply: admission and discharge on the same day equals 1 day; all days are counted during a period of admission except for the day of discharge; and leave days are excluded from the total. Note that the number of patient days reported to the National Mental Health Establishments Database is not directly comparable with either the number of patient days reported to the National Hospital Morbidity Database (Admitted patient mental health-related care section) or the number of residential care days reported to the National Residential Mental Health Care Database (Residential mental health care section).|
|Private psychiatric hospital||A private psychiatric hospital is an establishment devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders. From 2017–18, all private hospital data is sourced from the Private Psychiatric Hospitals Data Reporting and Analysis Service (PPHDRAS). Data on expenditure and Staffing (FTE) are not collected in PPHADRAS. Up to 2016–17, data were sourced from the Private Health Establishments Collection (PHEC), held by the Australian Bureau of Statistics (ABS), which identifies private psychiatric hospitals as those that are licensed/approved by a state or territory health authority, and which cater primarily for admitted patients with psychiatric, mental or behavioural disorders, that is, providing 50% or more of the total patient days for psychiatric patients. The data published in this section also include psychiatric units or wards in private hospitals. Further information can be found in the data source section.|
|Program type||Public sector specialised mental health hospital services can be categorised based on program type, which describes the principal purpose(s) of the program rather than the classification of the individual patients. Acute care admitted patient programs involve short‑term treatment for individuals with acute episodes of a mental disorder, characterised by recent onset of severe clinical symptoms that have the potential for prolonged dysfunction or risk to self and/or others. Non‑acute care refers to all other admitted patient programs, including rehabilitation and extended care services (see METEOR identifier 288889).|
|Psychiatric units or wards||Psychiatric units or wards are specialised units or wards that are dedicated to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders.|
|Public acute hospital||A public acute hospital is an establishment that provides at least minimal medical, surgical or obstetric services for admitted patient treatment and/or care and provides round‑the‑clock comprehensive qualified nursing services as well as other necessary professional services. They must be licensed by the state or territory health department or be controlled by government departments. Most of the patients have acute conditions or temporary ailments and the average length of stay is relatively short.|
|Public psychiatric hospital||A public psychiatric hospital is an establishment devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders that is controlled by a state or territory health authority and offers free diagnostic services, treatment, care and accommodation to all eligible patients.|
|Service setting||Staffing of specialised mental health service units is reported as service setting level data for three specialist mental health service types. These settings are admitted patient services in public psychiatric hospitals and public acute hospitals with specialised psychiatric units or wards; Community mental health care services; Residential mental health care services, including government and non-government-operated services; and at the Organisational overhead setting. The Organisational overhead setting level has been included from 2012–13 capturing staff employed by specialised mental health service organisations, performing organisational management roles.|
|Specialised mental health service organisation||A specialised mental health service organisation is a separate entity within states and territories responsible for the clinical governance, administration and financial management of services providing specialised mental health care. For most states and territories, a specialised mental health service organisation is equivalent to the area/district mental health service. These organisations may consist of one or more specialised mental health service units, sometimes based in different locations. Each separately identifiable unit provides either specialised mental health admitted patient hospital services, Residential mental health care services or Community mental health care services (METEOR identifier 286449).|
Staff numbers reported in this section refer to the average number of full-time-equivalent (FTE) staff employed, that is, the total hours actually worked divided by the number of normal hours worked by a full-time staff member (METEOR identifier 269172).
|Supported housing places||Supported housing places are reported by jurisdictions to describe the capacity of supported housing targeted to people affected by mental illness (METEOR identifier 390929). This is reported at the number available at 30 June and is therefore not comparable to the average available beds measures for specialised mental health hospital and residential services.|
Some specialised mental health services data are categorised using 5 target population groups (see METEOR identifier 682403):
Note that, in some states, specialised mental health beds for aged persons are jointly funded by the Australian and state and territory governments. However, not all states or territories report such jointly funded beds through the National Mental Health Establishments Database.
ABS (Australian Bureau of Statistics) 2018. Private hospitals, Australia, 2016–17. ABS Cat. no. 4390.0. Canberra: ABS.
AIHW (Australian Institute of Health and Welfare) 2015. National Health Data Dictionary 2012 version 16.2. Cat. no. HWI 131. Canberra: AIHW.
AIHW 2021. Aboriginal and Torres Strait Islander-specific primary health care: results from the OSR and nKPI collections. Cat. no. IHW 227. Canberra: AIHW. Viewed November 2021
APHA (Australian Private Hospitals Association) 2020. Private Hospital-based Psychiatric Services 1 July 2019 to 30 June 2020. Canberra: APHA.
DoH (Department of Health) 2010. National Standards for Mental Health Services . Canberra: Commonwealth of Australia. Viewed 3 March 2021.
DoH 2013. National mental health report: tracking progress of mental health reform in Australia, 1993–2011. Canberra: Commonwealth of Australia.
PMHA (Private Mental Health Alliance) 2013. Private Hospital-based Psychiatric Services 1 July 2011 to 30 June 2012. PMHA-CDMS annual statistical report for the 2011–2012. Private Mental Health Alliance.
PPHDRAS (Private Psychiatric Hospitals Data Reporting and Analysis Service) 2020. Private Hospital-based Psychiatric Services 1 July 2019 to 30 June 2020. Viewed November 2021.
Data coverage includes the time period 1992–93 to 2020–21. This section was last updated in March 2023.