Facilities

Summary

Key points

  • 161 public hospitals and 68 private hospitals provided specialised mental health services for admitted patients during 2019-20.
  • 7,019 specialised mental health public hospital beds were available in 2019–20; providing 2.3 million patient days to people in hospital.
  • 3,494 mental health beds were available in private hospitals in 2019–20.
  • 2,438 residential mental health beds were available during 2019–20, with over two-thirds operated by government organisations.
  • 13,948 full-time-equivalent staff were employed by Community mental health care services in 2019–20.

Specialised mental health care is delivered in and by a range of facilities in Australia 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.

There were 1,731 specialised mental health care facilities providing care in 2019–20 (Figure FAC.1.1).

Figure FAC.1: Number of specialised mental health care facilities, available beds and activity in Australia, 2019–20

Figure FAC.1.1 shows the number of facilities and allocation of bed and patient activity spilt into four groups of specialised mental health care facilities: public hospitals, private hospitals, Residential mental health care services and Community mental health care services.

Figure FAC.1.2 shows the number of facilities for all facility types from 2005–06 to 2019–20. There was a total of 1,254 specialised mental health facilities in 2005–06 which increased to 1,731 in 2019–20. There were a total of 927 community mental health service facilities in 2005–06 which increased to 1,321 in 2019–20. A total of 77 government operated residential mental health service facilities in 2005–06 which increased to 111 in 2019–20. A total of 58 non-government operated residential mental health service facilities in 2005–06, which peaked to 89 facilities in 2014–15 and then decreased to 70 in 2019–20. A total of 43 private psychiatric hospital facilities in 2005–06, which increased to 68 in 2019–20. A total of 134 public acute hospital with specialised psychiatric unit or ward facilities in 2005–06, which increased to 144 in 2019–20. A total of 15 public psychiatric hospital facilities in 2005–06, which increased to 17 in 2012–13 and has remained the same till 2019–20.

Social and emotional wellbeing services for Aboriginal and Torres Strait Islander people

In addition to the specialised mental health care facilities described above, Aboriginal and Torres Strait Islander people may access a range of culturally appropriate mental health services provided by Australian and 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 2021). 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 2019–20, 442 social and emotional wellbeing staff were located across Australia, providing approximately 234,220 client contacts (AIHW 2021). For more information on the organisation profile, staffing and types of services provided by SEWB services, see the Aboriginal and Torres Strait Islander specific primary health care: results from the nKPI and OSR collections (2019–20).

Specialised mental health service organisations

There were 174 Specialised mental health service organisations responsible for the administration of the 1,663 state and territory specialised mental health facilities (excluding private hospitals) during 2019–20. Of these, almost two-thirds (111 organisations or 63.8%) provided two or more types of services.

Of organisations that provided 2 or more types of services within an organisational structure, the most common pairing was specialised mental health public hospital services (includes public acute hospitals and public psychiatric hospitals) and Community mental health care services (63 or 36.2%). These organisations accounted for about half of the beds and patient days (51.0% and 49.8% respectively) provided by specialised mental health public hospital services and over two-fifths (42.0%) of all community mental health care service contacts.

Furthermore, more than three-quarters provided specialised Community mental health care services (137 or 78.7%). About two-thirds provided specialised mental health public hospital services (114 or 65.5%), and almost half provided Residential mental health services (80 or 46.0%).

Figure FAC.2: Specialised mental health organisations, by level of consumer committee representation, 1993–94 to 2019–20

A stacked area chart showing the level of consumer committee representation arrangements in mental health organisations from 1993–94 to 2019–20. Level 1 consumer representation has grown from a minority to majority arrangement over this time period. Level 2 consumer participation has consistently been the least common arrangement from 2003–04 onwards. Refer to Table FAC.8

Key:
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 data: Specialised mental health care facilities 2019–20 tables.

Specialised mental health beds and patient days

During 2019–20, there were 12,961 specialised mental health beds available nationally, with 7,019 beds provided by public hospital services, 3,494 by private hospitals, and 2,438 by Residential mental health care services (Figure FAC.3).

Figure FAC.3: Distribution of specialised mental health beds in Australia, 2019-20

Figure FAC.3 shows the distribution of specialised mental health beds in 2019–20. The table shows that the majority of beds were provided by hospitals, while residential beds accounted for approximately 1 in 4 beds. Public hospitals provided more than twice the number of beds that private hospitals provided and the majority of 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.

Public sector specialised mental health hospital beds

In 2019–20, there were 7,019 public sector specialised mental health hospital beds available in Australia. About three quarters of these (77.4% or 5,434 beds) were in specialised psychiatric units or wards within public acute hospitals, with the remainder in public psychiatric hospitals (1,584 beds).

New South Wales (33.2) had the highest rate of beds per 100,000 population in 2019–20, while the Northern Territory had the lowest (17.5), compared to the national rate of 27.5.

Public sector specialised mental health hospital beds can also be described by the target population or program type category of the specialised mental health service unit, or a combination of both.

Figure FAC.4: Public sector specialised mental health hospital beds, by target population, states and territories, 2019–20

Stacked bar chart showing the proportion of public sector specialised mental health hospital beds by target population and states and territories in 2019–20. Target Populations are: General, Child and adolescent, Youth, Older person and Forensic. Beds in General services had the highest proportion of beds per 100,000 across all jurisdictions. Refer to Table FAC.14.

Figure FAC.5: Residential mental health service beds per 100,000 population, by hours staffed and target population, states and territories, 2019–20

Figure FAC.5 shows a stacked vertical bar chart of residential mental health service beds per 100,000 population by hours staffed and states and territories in 2019–20. NSW (0.5), Vic (20.4), Qld (6.4), WA (12.4), SA (9.1), Tas (30.3), ACT (4.9), NT (14.6) and national total (9.5). Western Australia was the only jurisdiction where non-24-hour staffed residential services provided more beds per 100,000 population than 24-hour staffed services. 24-hour staffed services provided more beds across all other jurisdictions. Refer to Table 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 mental health hospital services (inpatient care) or 24-hour staffed Residential mental health care services. Comparisons between states and territories are possible when the data for these different types of 24‑hour staffing are combined.

Victoria had the highest rate of 24-hour staffed public sector beds per 100,000 population (39.8) in 2019–20, followed by Tasmania (39.4), while Queensland (31.9) and the Northern Territory (32.1) had the lowest rates, compared with the national average of 35.2 (Figure FAC.6). In New South Wales (21.8), Victoria (18.7), Queensland (17.1), Western Australia (26.7), South Australia (21.9) and Northern Territory (17.5) the highest rate was provided by acute hospital services. In Tasmania 24-hour staffed residential services (20.4) had the highest rate.

Figure FAC.6: Specialised mental health hospital beds per 100,000 population, by 24-hour care setting, states and territories, 2019–20

Stacked vertical bar chart showing specialised mental health beds per 100,000 population, by 24-hour care setting and states and territories in 2019–20. NSW (33.5), Vic (39.8), Qld (31.9), WA (34.8), SA (34.8), Tas (39.4), ACT (33.5), NT (32.1), Total (35.2). In New South Wales (21.8), Victoria (18.7), Queensland (17.1), Western Australia (26.7), South Australia (21.9) and Northern Terriotory (17.5) the highest number of beds per 100,000 were provided by acute hospital services.  In Tasmania (20.4) 24-hour staffed residential services had the highest number of beds per 100,000 population. Refer to Table FAC.23.

Private hospital specialised mental health beds

There were 3,494 available beds (13.7 per 100,000 population) in private psychiatric hospitals in 2019–20, including specialised units or wards in private hospitals.

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 services. The total number of patient days is reported by specialised mental health service units.

Staffing of state and territory specialised mental health care facilities

State and territory specialised mental health care services include public psychiatric hospitals, psychiatric units or wards in public acute hospitals, Community mental health care services and government and non‑government‑operated Residential mental health care services.

In 2019–20, there were 139.6 FTE staff per 100,000 population nationally employed in specialised mental health care services (Figure FAC.7).

The Northern Territory (207.0) had the highest rate of FTE staff per 100,000 population, while Victoria (132.4) had the lowest. Nurses were the largest full-time-equivalent staff category across all jurisdictions.

In 2019–20, of the 35,686.3 FTE staff employed in state and territory specialised mental health care services, about half were nurses (18,196.7 FTE or 51.0%) with the majority registered nurses (15,665.3 FTE or 43.9%). Diagnostic and allied health professionals (7,133.9 FTE or 20.0%) made up the second largest group of staff, comprising mostly social workers (2,574.6 FTE) and psychologists (1,993.3 FTE). Salaried medical officers made up 10.9% of FTE staff, with similar numbers of consultant psychiatrists and psychiatrists (1,719.3 FTE), and psychiatry registrars and trainees 1,855.4 FTE).

Figure FAC.7: Full-time-equivalent staff per 100,000 population by staffing category, states and territories, 2019–20

Vertical stacked bar chart showing full-time-equivalent staff per 100,000 population by staffing category and jurisdictions in 2019–20. 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.

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 (15,718 FTE or 44.1%) of state and territory specialised mental health care services staff were employed in public hospital specialised mental health services. Community mental health care services employed the next largest number (13,948 FTE or 39.1%). Since 1993–94, the number of staff employed in specialised mental health admitted patient hospital services has ranged between around 11,000 FTE to around 16,000 FTE, while the number employed by Community mental health care services has tripled (from 4,197 FTE in 1993–94 to 13,948 FTE in 2019–20).

Figure FAC.8: Full-time-equivalent health care providers per 100,000 population, by service setting, state and territory specialised mental health service units, 1992–93 to 2019–20

Line graph showing Full-time-equivalent health care providers per 100,000 population, state and territory specialised mental health service units, by service setting, 1992–93 to 2019–20. This rate was consistently highest for Hospital admitted patient service settings, ranging between 45.1 and 57.1 (in 2000–01 and 1992–93 respectively), and was most recently 56.7 (in 2019–20). The rate was consistently second highest for Community mental health care service settings, which increased from 19.1 to 49.0 between 1992–93 and 2019–20. The rate for Residential mental health care service settings increased from 4.0 to 8.9 between 1992–93 and 2019-20 peaking at 9.0 in 2018-19 and with a low of 3.4 in 1993–94. The Organisation overhead setting was reported on from 2012–13, with a rate ranging between 3.7 and 5.7 during the past 8 reporting periods. Refer to Table FAC.43.

Key concepts
Key concept Description
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: 

  • are operated by a state or territory government
  • employ mental health-trained staff on‑site for a minimum of 6 hours per day and at least 50 hours per week
  • provide rehabilitation, treatment or extended care to residents for whom the care is intended to be on an overnight basis and in a domestic‑like environment
  • encourage the resident to take responsibility for their daily living activities.
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:

  • Level 1: the service unit has been reviewed by an external accreditation agency and was judged to have met the standards.
  • Level 2: the service unit was in the process of being reviewed by an external accreditation agency and was judged to have met some but not all of the National Standards for Mental Health Services.
  • Level 3: the service unit was in the process of being reviewed by an external accreditation agency but the outcomes are not known; or the service unit is booked for review by an external accreditation agency.
  • Level 4: the service unit does not meet the criteria detailed in levels 1 to 3.
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 (Overnight 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

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.
Target population

Some specialised mental health services data are categorised using 5 target population groups (see METEOR identifier 682403):

  • Child and adolescent services focus on those aged under 18 years.
  • Older person programs focus on those aged 65 years and over.
  • Forensic health services provide services primarily for people whose health condition has led them to commit, or be suspected of, a criminal offence or make it likely that they will reoffend without adequate treatment or containment.
  • General programs provide services to the adult population, aged 18 to 64; however, these services may also provide assistance to children, adolescents or older people. 
  • Youth services target children and young people generally aged 16–24 years.

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.

Data coverage includes the time period 1992–93 to 2019–20. This section was last updated in February 2022.