Mental health prescriptions

Summary

Key points

  • 42.7 million mental health-related medications (subsidised and under co-payment) were dispensed in 2020–21.

  • 4.5 million patients (17.7% of the Australian population) filled a prescription for a mental health-related medication in 2020–21, with an average of 9.4 prescriptions per patient.

  • 62.3% of mental health-related prescriptions filled were subsidised by the PBS/RPBS in 2020–21.

  • 84.7% of mental health-related prescriptions filled were prescribed by GPs; 7.5% prescribed by psychiatrists; 4.9% prescribed by non-psychiatrist specialists in 2020–21.

  • 73.1% of mental health-related prescriptions filled were for Antidepressant medications in 2020–21.

This section presents Pharmaceutical Benefits Scheme (PBS) information on for mental health-related medications; both subsidised prescriptions and under co-payment prescriptions (that is, prescriptions that cost less than the threshold for subsidy under the PBS). Mental health‑related medications reported in this section comprise Psycholeptics, Antipsychotics, Anxiolytics, Hypnotics and sedatives, Psychoanaleptics, Antidepressants, and Psychostimulants, agents used for Attention-deficit hyperactivity disorder (ADHD) and nootropics prescribed by all medical practitioners.

For further information on the PBS and Repatriation Pharmaceutical Benefits Scheme (RPBS) and the medications covered by these schemes, refer to the data source section. Related data on expenditure on medications subsidised under the PBS and RPBS are presented in the Expenditure on mental health-related services section.

From February 2020, a range of restrictions on travel, business, social interaction and border control were introduced to prevent and reduce the spread of SARS-CoV-2, the virus that causes COVID-19. While this report explores the impact on mental health‑related prescriptions, the AIHW has published a report on the Impacts of COVID‑19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use more broadly.

Spotlight data: How many patients received a mental health-related prescription in 2020-21?

Figure PBS.1: Number of patients and prescriptions dispensed by demographic and geographic variables, 2014-15 to 2020-21

Interactive map and waterfall chart showing the number of patients who received a mental health related prescription and the number of prescriptions dispensed by age group and sex from 2014–15 to 2020–21 across state or territory, Primary Health Network and Statistical Area 3. In 2020–21, 4,545,969 patients in total received a mental health-related prescription.

Overview

There were 42.7 million prescriptions filled for mental health-related medications (both subsidised and under co-payment)in Australia in 2020–21. This is equivalent to 1,663.5 mental health-related prescriptions per 1,000 population. These medications were dispensed to 4.5 million patients, which equates to 17.7% of Australians.

There was an average of 9.4 prescriptions filled per patient in 2020–21. Of the 42.7 million mental health-related prescriptions, 26.6 million were subsidised under the PBS/RPBS and filled by 2.6 million patients; an average of 10.3 subsidised prescriptions per patient in 2020–21.

Under the PBS and the RPBS, the Australian Government sets a maximum 'co-payment' amount that people pay towards the cost of their medicines. The co-payment is the amount people pay towards the cost of their PBS subsidised medicine. Many PBS medicines cost significantly more than the co-payment amount. From 1 January 2022, a person may pay up to $42.50 for most PBS medicines or $6.80 if he/she has a concession card. The amount of co-payment is adjusted on 1 January each year in line with the Consumer Price Index (CPI). The Australian Government pays pharmacies the difference between a consumer's co-payment and the PBS price of a medicine, as listed on the Schedule of Pharmaceutical Benefits. Some prescriptions are priced below the co-payment threshold for a patient, so the consumer pays the total cost, and the government does not contribute. Further information is available in Data source.

Unless otherwise stated in this report, prescriptions filled (or dispensed) include total prescriptions, that is, both subsidised and under co-payment arrangements.

Patient characteristics

More than 1 in 6 Australians (17.7% of the Australian population) filled a mental health-related prescription in 2020–21. Tasmania had the highest proportion (23.6% of the population), while New South Wales (16.4%) had the lowest (excluding the Northern Territory – see the Note accompanying Figure PBS.2). Victoria (16.8%) and the Australian Capital Territory (17.4%) had similar rates to New South Wales.

Figure PBS.2: People (per cent) dispensed one or more mental health-related medications, by states and territories, 2020–21

Figure PBS.2: People (per cent of the population) dispensed one or more mental health-related prescriptions, states and territories, 2020-21.

Bar chart showing the per cent of patients filling mental health-related prescriptions (subsidised and subsidised and under co-payment) by states and territories in 2020–21. New South Wales had 9.6% of the population filling subsidised prescriptions, Vic (9.5%), Qld (11.6%), WA (10.1%), SA (12.1%), Tas (15.1%), ACT (7.5%), NT (4.6%), Australian total (10.3%). When considering subsidised and under co-payment prescriptions: NSW (16.4%), Vic (16.8%), Qld (19.8%), WA (18.4%), SA (19.4%), Tas (23.6%), ACT (17.4%), NT (9.8%), Australia total (17.7%). Refer to Table PBS.2.

Note: A proportion of the Australian Government subsidy of pharmaceuticals in remote Aboriginal communities (primarily the Northern Territory) is funded through the Aboriginal Health Services program, where drugs are supplied directly to patients and hence are not included in this data. Therefore, figures presented for the Northern Territory are considered to be an underestimate.

Source data: Mental health-related prescriptions 2020–21 tables

The proportion of people filling mental health-related prescriptions in 2020–21 was lowest for the youngest age groups (0.2% of people aged 0–4 years, 4.8% of people aged 5–11 years and 9.5% of people aged 12–17 years), increasing by age group to 41.0% for people aged 85 years and over (Figure PBS.3). A higher proportion of females filled mental health-related prescriptions than males (21.0% and 14.3% respectively). A greater proportion of people living in Inner regional areas were dispensed mental health-related medications (22.2%), followed by people living in Outer regional areas (20.2%), Major cities (16.5%), Remote (14.9%) and Very remote (8.5%) areas.

Figure PBS.3: People (per cent) dispensed one or more mental health-related medications, by patient demographics, 2020–21

Figure PBS.3: People (per cent) dispensed with mental health-related medications, by patient demographics, 2020–21.

Horizontal bar chart showing the per cent of people filling mental health-related prescriptions (subsidised and under co-payment), by patient demographics for 2020–21. Proportions were lowest for people aged 0–4 years (0.2%) gradually increasing to 41.0% for those 85 years and over. The proportion of females (21.0%) filling prescriptions was higher than males (14.3%). Proportions varied among patient area of usual residence: Major cities (16.5%), Inner regional (22.2%), Outer regional (20.2%), Remote (14.9%) and Very remote (8.5%). Refer to Table PBS. 4.

The population rate for females aged 85 and over filling mental health‑related prescriptions was higher than all other age groups for all drug types, except for Psychostimulants, agents used for ADHD and nootropics where those aged 12–17 had the highest population rate. A similar pattern was seen in males with the highest population rate for Psychostimulants, agents used for ADHD and nootropics also for those aged 12–17. When comparing males and females, a higher proportion of males were dispensed Psychostimulants, agents used for ADHD and nootropics, while a higher proportion of females were dispensed Anxiolytics, hypnotics and sedatives, and Antidepressants. The rates for Antipsychotics were the same for males and females.

Over time

The proportion of the population filling PBS and RPBS mental health-related prescriptions has risen from 16.7% in 2016–17 to 17.7% in 2020–21. The proportion of people filling subsidised mental health-related prescriptions has declined by an average of 0.9% per year until 2019–20, from 9.8% in 2016–17 to 9.7% in 2019–20, however it has seen a rise to 10.3% in 2020–21 (Figure PBS.4).

Figure PBS.4: People (per cent) dispensed one or more mental health-related medications 2007–08 to 2020–21

Figure PBS.4: People (per cent of population) dispensed with mental health-related prescriptions, 2007-08 to 2020-21.

Line chart showing the rate  of filled mental health-related subsidised prescriptions, and subsidised and co-payment prescriptions, by year. Rates of subsidised prescriptions have fluctuated from a high of 11.0% (in 2010–11) and a low of 9.6 in 2018–19. Rates for total prescriptions filled (subsidised and under co-payment) are only available from 2012–13 and have been steadily increasing from 15.9% in 2012–13 to 17.7% in 2020–21. Refer to Table PBS.3.

Prescriptions by type

In 2020–21, Tasmania had the highest rate of mental health-related prescriptions filled for subsidised prescriptions (1,558.1 per 1,000 population) and total prescriptions (2,301.1).

The Australian Capital Territory had the lowest rate of subsidised prescriptions filled (737.8) and New South Wales had the lowest rate of total prescriptions (1,511.8).

Due to arrangements in the Northern Territory where prescriptions medications are supplied through the Aboriginal Health Services program, the Northern Territory's PBS/RPBS statistics are recognised as an underestimate.

Figure PBS.5: Number of mental health-related prescriptions per 1,000 population, by states and territories, 2020–21

Figure PBS.5: Mental health-related prescriptions (per 1,000 population), by states and territories 2020-21.

Bar chart showing rate of mental health-related prescriptions filled (subsidised and under co-payment) per 1,000 population by jurisdiction in 2020–21. Subsidised prescription rates: NSW (951.8), Vic (991.4), Qld (1,178.0), WA (1,010.0), SA (1,233.1), Tas (1,558.1), ACT (737.8), NT (382.2), National total (1,036.9). Subsidised and under co-payment prescription rates: NSW (1,511.8), Vic (1,614.0), Qld (1,864.2), WA (1,703.5), SA (1,847.3), Tas (2,301.1), ACT (1,593.7), and NT (785.1), National total (1,663.5). Refer to Table PBS.11.

Note: A proportion of the Australian Government subsidy of pharmaceuticals in remote Aboriginal communities (primarily the Northern Territory) is funded through the Aboriginal Health Services program, where drugs are supplied directly to patients and hence not included in this data. Therefore, figures presented for the Northern Territory are considered to be an underestimate.

Source data: Mental health-related prescriptions 2020–21 tables.

Prescription characteristics

Of the 42.7 million mental health-related medications dispensed in 2020–21, the majority (84.7%) were prescribed by general practitioners (GPs), with another 7.5% prescribed by psychiatrists and 4.9% by non-psychiatrist specialists. These proportions were similar for subsidised prescriptions.

The majority of total mental health-related prescriptions filled were for Antidepressants (73.1%, or 31.2 million) in 2020–21, followed by Antipsychotics (10.1%), Anxiolytics (7.6%), Psychostimulants, agents used for ADHD and nootropics (4.7%) and Hypnotics and sedatives (4.4%) (Figure PBS.6). Among the categories of medications, the majority of prescriptions were issued by GPs, except for Psychostimulants, agents used for ADHD and nootropics. Similar patterns were observed for subsidised prescriptions.

Figure PBS.6: Number of mental health-related prescriptions, by type of medication and prescribing medical practitioner, 2020–21

Figure PBS.6: Mental health-related prescriptions, by type of medication and prescribing medical practitioner, 2020-21.

Horizontal bar chart showing the number of mental health-related prescriptions filled (subsidised & under co-payment), by ATC group of medication and prescribing medical practitioner, 2020–21. Antidepressants were prescribed by: GPs (28.2 million), non-psychiatrist specialists (0.8), psychiatrists (1.7). Antipsychotics: 3.0, 0.1, 0.7. Anxiolytics: 3.0, 0.1, 0.2. Hypnotics and sedatives: 1.8, 0.1, 0.04 Psychostimulants, agents used for ADHD and nootropics: 0.4, 1.0, 0.6. Refer to Table PBS.11.

Antidepressants and Antipsychotics had the highest average number of total prescriptions filled per patient (8.9 and 8.7, respectively) in 2020–21. Psychostimulants, agents used for ADHD and nootropics had a lower number of prescriptions filled, but had the third highest rate of prescriptions filled per patient (7.0). A similar pattern was observed for subsidised prescriptions.

Females had a higher rate of mental health-related prescriptions filled (1,984.6 per 1,000 population) than males (1,316.4) in 2020–21. However males and females filled a similar number of scripts per patient, averaging 9.2 for males and 9.4 for females.

Over time

For the period 2016–17 to 2020–21, the rate (per 1,000 population) of total mental health-related prescriptions being filled increased from 1,506.1 to 1,663.5, an average annual increase of 2.5%. The rate of PBS/RPBS subsidised prescriptions being filled also increased over the same period from 982.6 to 1,036.9 per 1,000 population, an average annual increase of 1.4% (Figure PBS.7). This is partly due to price reductions on medications no longer under patent. More information about this is available in the Expenditure on mental health-related services section.

Figure PBS.7: Number of mental health-related prescriptions per 1,000 population, 2006–07 to 2020–21

Figure PBS.7: Rate (per 1,000 population) of  mental health-related prescriptions 2005-06 to 2020-21.

Line chart showing the rate of mental health-related prescriptions filled (subsidised and subsidised and co-payment per 1,000 population between 2006–07 and 2020–21. Rates of subsidised prescriptions: 988.8 for 2006–07, 984.3 for 2008–09, 1,036.7 for 2010–11, 1,045.9 for 2012–13, 1,018.8 for 2014–15, 982.6 for 2016–17, 971.9 for 2018–19 and 1,036.9 for 2020–21. Rates for subsidised and co-payment prescriptions: 1,378.5 for 2012–13, 1,424.6 for 2013–14, 1,456.3 for 2014–15, 1,487.8 for 2015–16, 1,506.1 for 2016–17, 1,524.0 for 2017–18, 1,549.0 for 2018–19, 1,594.6 for 2019–20 and 1,663.5 for 2020–21. Refer to Table PBS.12.

Between 2016–17 and 2020–21, the rate (per 1,000 population) of mental health-related prescriptions filled decreased from 152.2 to 126.5 for Anxiolytics and from 98.0 to 73.7 for Hypnotics and sedatives, an average annual decrease of 4.5% and 6.9% respectively. Conversely, the prescription rates have increased over the same period of time from 164.6 to 168.2 for Antipsychotics; from 1042.7 to 1216.7 for Antidepressants; and from 48.5 to 78.4 for Psychostimulants, agents used for ADHD and nootropics, an average annual increase of 0.5%, 3.9% and 12.7% respectively.

Prescriptions during COVID-19 pandemic

Analyses of prescriptions for mental health‑related medications by financial year quarter have been included to show seasonal variations in medication dispensed, and provide more insight into the impact of events such as the COVID-19 pandemic. These include service and person counts disaggregated by medication type, age group and sex (Tables PBS.8–9, PBS.18–19).

Between 2019–20 and 2020–21, the January to March quarter had the highest percentage increase in both the total prescriptions filled and the patients dispensed one or more mental health-related medications. This is consistent with the general trend seen across the PBS, with a 23.1% increase in the number of medications dispensed in March 2020 compared with March 2019.

Regional reporting

Information on mental health-related prescriptions can also be reported at the sub-jurisdictional level, within state and territory boundaries. See also Figure PBS.1.

Where do I go for more information?

You might also be interested in: Medicare-subsidised mental health-specific services.

Key concepts
Key concept Description
Mental health‑related medications Mental health‑related medications are defined in this section as 5 selected medication groups as classified in the Anatomical Therapeutic Chemical (ATC) Classification System (WHO 2021), namely antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A), and psychostimulants, agents used for ADHD and nootropics (code N06B)—prescribed by all medical practitioners (that is, general practitioners (GPs), non‑psychiatrist specialists and psychiatrists).
Patient co-payment Under the PBS/RPBS the cost of prescription medicines is subsidised by the Australian Government. Patients are classified as either general or concessional, and are required to pay a patient co-payment towards the cost of their prescription according to their patient status. At 1 January 2019 the co-payment was $40.30 (general) and $6.50 (concessional).
Prescriptions The information on prescriptions in this section is sourced from the processing of the PBS/RPBS and refers to medications prescribed by medical practitioners and subsequently dispensed by approved suppliers (community pharmacies or hospital pharmacies). Consequently, it is a count of prescriptions dispensed rather than a count of the prescriptions written by medical practitioners.
Subsidised prescriptions

A PBS/RPBS prescription is subsidised when the dispensed price of a medication exceeds the patient co-payment. The PBS/RPBS covers the difference between the full cost of the medication and the patient co-payment.

Under co-payment prescriptions

A PBS/RPBS prescription is classified as under co-payment when there is no government subsidy as the dispensed price of the prescription does not exceed the patient co-payment, and the patient pays the full cost of the medication.

Data coverage includes the time period 2005–06 to 2020–21. Data in this section were last updated in August 2022.