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Specialised mental health organisations employ mental health consumer workers and mental health carer workers for their lived experience of mental illness and caring for people with mental illness.

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).

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, 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).

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%).

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.

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.

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.

National Mental Health Establishments Database

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 validation

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.

National standards for mental health services review status

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.

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).

Rate calculations

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 health reporting

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.

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.