Residential services

Summary

Key points

  • 9,051 episodes of residential care were recorded for an estimated 7,180 residents in 2020–21.
  • Schizophrenia was the most frequently reported principal diagnosis grouping in 2020–21 (23% of episodes), followed by Specific personality disorders (16%) and Depressive episode (10%).
  • 17% of residents had an involuntary mental health legal status.
  • 58% of completed residential mental health care episodes lasted 2 weeks or less, with 2.7% of episodes lasting longer than 1 year.

Residential mental health care (RMHC) services provide specialised mental health care on an overnight basis in a domestic-like environment. RMHC services may include rehabilitation, treatment or extended care. Over the last 5 years to 2020–21 the number of episodes have increased from at an average annual rate of about 6%, while the number of residential care days fluctuated during this period.

Data from the National Residential Mental Health Care Database (NRMHCD) are used to describe the care provided by these services. Data is contributed by each state and territory. More information about the NRMHCD is available in the data source section.

During 2020–21, there were about 7,180 residents estimated to be receiving RMHC in Australia, of which 55% were female. The estimated number of residents among states and territories varied during 2020–21, with about 3,670 in Victoria, 1,450 in Queensland, 1,080 in South Australia, 560 in Tasmania, 190 in Northern Territory, 170 in Western Australia, and 70 in New South Wales.

Figure RMHC.1: Residential mental health care dashboard

Infographic containing a map of Australia showing residential mental health care episodes by mental health legal status (Involuntary, voluntary and total) by year; a pie chart showing proportions of 6 principal diagnosis categories; and a line chart showing the number of residents and episodes of care from 2005–06 to 2020–21 (refer to Table RMHC.2, RMHC.13 and Table RMHC.15).

Note: States and territories without published data will appear as ‘0’ or ‘0.0’ on ‘Mental health legal status’ map.

Service provision

There were about 9,050 continuing and completed episodes of residential care in 2020–21, with about 348,960 residential care days provided to an estimated 7,180 residents. This equates to an average of almost one and a half episodes of care per resident and 39 residential care days per episode.

Figure RMHC.2: Residential mental health care services in Australia by location

Infographic containing a map of Australia showing residential mental health care episodes, estimated number of residents and residential care days (rate per 10,000 population and number), by state or territory, Primary health network (PHN) and Statistical area 3 (SA3) for the years 2012–13 to 2020–21 (refer to Table RMHC.18 and Table RMHC.19).

Notes

  1. Comparisons between jurisdictions and years should be made with caution due to the variability in the different collections.
  2. Australian Capital Territory did not report any residential mental health services in 2019–20 and 2020–21. National data excludes Australian Capital Territory.
  3. States and territories without published data will appear as ‘0’ or ‘0.0’

Source data: Residential mental health care 2020–21 tables

Resident demographics

A higher number of females than males received RMHC in 2020–21 (55% females). People aged 18–24 years accessed care at a higher rate than other age groups (6 people per 10,000 population) in 2020–21. There were no residents aged under 12 years.

Aboriginal and Torres Strait Islander People comprised about 8% of residents in 2020–21. The rate of Indigenous residents per 10,000 population was more than double the rate for non-Indigenous (7 compared to 3).

People born in Australia accessed care in 2020–21 at about 3 times the rate for people born overseas (3 per 10,000 population compared to 1 per 10,000). About 86% of residents in 2020–21 were born in Australia.

People in Inner regional areas accessed residential mental health care at a higher rate than other remoteness areas (4 people per 10,000 population). The area of usual residence that had the lowest rate of people accessing RMHC was Major cities areas (2 people per 10,000 population).

People in SEIFA quintile 1 (most disadvantaged) accessed care at a rate higher than all other quintiles (4 people per 10,000 population) and comprised of 27% of the population accessing care (Figure RMHC.3).

Figure RMHC.3: People accessing residential mental health care overtime, by resident demographics, 2020–21

Horizontal bar chart showing the rate (per 10,000 population), per cent or number of people accessing residential mental health care by demographic variables of age group, sex, Indigenous status, country of birth, remoteness area and SEIFA quintile in 2020–21. Those aged 11 years and under had the lowest rate per 10,000 population at 0.0, while those aged 18-24 years had the highest rate at 6.3. 2.5 males and 3.0 females per 10,000 population received residential mental health care services. 7.2 Indigenous Australians per 10,000 population and 2.6 non-Indigenous Australians received residential mental health care services. 3.4 people per 10,000 population who were born in Australia and 1.3 people were born overseas, received residential mental health care services. The highest rate for area of usual residence was Inner regional, 4.4 people per 10,000 population in received residential mental health care services, while those in Major cities had the lowest rate of 2.2 people per 10,000 population. Per 10,000 population in SEIFA Quintile 1 (most disadvantaged) had the highest rate with 3.7 people received residential mental health care services, while Quintile 5 had the lowest at 1.5 (refer to Table RMHC.3).

Principal diagnoses

The 5 most commonly reported mental health-related principal diagnoses for residential mental health care episodes were:

  • Schizophrenia (23%),
  • Specific personality disorders (16%),
  • Depressive episode (10%),
  • Schizoaffective disorders (9%) and;
  • Bipolar affective disorders (7%) (Figure RMHC.4).

Figure RMHC.4: Proportion of residential mental health care episodes for 5 commonly reported principal diagnoses, 2020–21

A horizontal bar chart showing the number of residential mental health care episodes with all principal diagnoses in 2020–21. Schizophrenia was recorded for 2,070 of residential mental health care episodes; Specific personality disorders, 1,426; Depressive episode, 862; Schizoaffective disorders, 789, and Bipolar affective disorders, 673. With a filter, the horizontal bar chart showing the proportion (per cent) of residential mental health care episodes in 2020–21 in which one of the 5 most common principal diagnoses was reported. Schizophrenia was recorded for 22.9% of residential mental health care episodes; Specific personality disorders, 15.8%; Depressive episode, 9.5%; Schizoaffective disorders, 8.7%; and Bipolar affective disorders, 7.4% (refer to Table RMHC.15).

Characteristics of residential care episodes

In 2020–21, 8,060 residential episodes of care formally ended before the end of the reference period (on or before 30 June 2021). This is known as a completed residential stay. The highest completed episodes of care length was 2 weeks or less (58%) (Figure RMHC.5), followed by 2 weeks to 1 month (27%). A small number of episodes of care (3%) lasted longer than 1 year.

Figure RMHC.5: Residential mental health care episodes, by length of completed residential stay, 2006–07 to 2020–21

An interactive line chart showing the number of residential mental health care episodes by length of completed residential stay from 2006–07 to 2020–1921. In 2020–21, episodes lasting between 0 to 2 weeks comprised 57.7% of episodes; between 2 weeks to 1 month, 26.9%; between 1 and 3 months, 7.7%; between 3 and 6 months, 2.7%; between 6 and 12 months, 2.2%; between 1 and 5 years, 2.5%; more than 5 years, 0.2% (refer to Table RMHC.9).

Mental health legal status

Less than 1 in 5 (17%) RMHC episodes were for residents with an involuntary mental health legal status in 2020–21. Among the 5 most commonly reported principal diagnoses with an involuntary mental health legal status, Schizoaffective disorders (38%) accounted for the highest proportion of episodes. Specific personality disorders had the highest proportion of episodes of care with a voluntary mental health legal status (96%) (Figure RMHC.6).

Figure RMHC.6: Residential mental health care episodes for 5 commonly reported principal diagnoses, by mental health legal status, 2020–21

Two interactive charts. A stacked horizontal bar chart showing the residential mental health care episodes (number and per cent) for 5 of the most commonly reported principal diagnoses, by mental health legal status (voluntary or involuntary) in 2020–21. For Schizophrenia, there were 1,281 episodes with a voluntary mental health legal status and 715 with an involuntary mental health legal status; Schizoaffective disorders, 474 and 288; Bipolar affective disorders, 512 and 145; Depressive episode, 819 and 43; and Specific personality disorders, 1,373 and 53 (refer to Table RMHC.12).
A stacked vertical bar chart showing the proportion of residential mental health care episodes by mental health legal status from 2008–09 to 2020–21. In 2020–21, Queensland had the highest proportion of episodes with an involuntary mental health legal status (27%), and Western Australia had the lowest proportion (1.9%) (refer to Table RMHC.13).

Note: Australian Capital Territory did not report any residential mental health services in 2019–20 and 2020–21. National data excludes Australian Capital Territory.

Source data: Residential mental health care 2020–21 tables

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Key concepts

Key concept Description

Episodes of residential care

Episodes of residential care are defined as a period of care between the start of residential care (either through the formal start of the residential stay or the start of a new reference period (that is, 1 July)) and the end of residential care (either through the formal end of residential care, commencement of leave intended to be greater than 7 days, or the end of the reference period (that is, 30 June)). An individual can have one or more episodes of care during the reference period.

The state and territory mental health acts and regulations are designed to safeguard the rights and govern the treatment of patients with mental illness in admitted patient care, residential care and community-based services. The legislation varies between states and territories but all contain provisions for the assessment, admission and treatment of patients on an involuntary basis, defined as ‘persons who are compulsorily treated in hospital or in the community under state and territory mental health legislation for the purpose of assessment or provision of appropriate treatment or care’ (AIHW 2021).

Principal diagnosis

The principal diagnosis recorded for people who have an episode of residential mental health care is based on the broad categories listed in the Mental and behavioural disorders chapter (Chapter 5) of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM 11th edition). Further information can be found in the Health-related classifications section.

Resident

A resident is a person who receives residential care intended to be for a minimum of 1 night.

Residential care days

Residential care days refer to the number of days of care the resident received in the episode of residential care.

The number of days a resident was in residential care is calculated by subtracting the date on which the residential stay started from the episode end date and deducting any leave days. These leave days may occur for a variety of reasons, including receiving treatment by a health service or spending time in the community. Note that leave days taken prior to 2009–10 were not accounted for due to lack of data.

Residential mental health care

Residential mental health care refers to residential care provided by residential mental health services. A residential mental health service is a specialised mental health service that:

  • employs mental health trained staff on‑site

  • provides 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

  • encourages the residents to take responsibility for their daily living activities.

These services include those that employ mental health trained staff on-site 24 hours per day and other services with less intensive staffing. However, all these services employ on‑site mental health trained staff for some part of the day.

Residential stay

Residential stay refers to the period of care beginning with a formal start of residential care and ending with a formal end of the residential care. It may involve more than one reference period (that is, more than one episode of residential care).

Socio-Economic Indexes for Areas (SEIFA)

SEIFA is a product developed by the Australian Bureau of Statistics (ABS) that ranks areas in Australia according to relative socio-economic advantage and disadvantage. It consists of 4 indexes based on information from the five-yearly Census, each being a summary of a different subset of Census variables and focuses on a different aspect of socio-economic advantage and disadvantage. Further details are available from the ABS.

 

Data in this section were last updated in October 2022.