Mental health workforce

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Summary

Key points

  • There were 3,769 psychiatrists, 24,567 mental health nurses, 31,618 psychologists and 2,555 mental health occupational therapists working in Australia in 2020.
  • The paid lived experience workforce in specialised mental health care facilities has grown at an average annual rate of 15.9% from 2015–16 to 2019–20.

Although the definition of a ‘mental health worker’ may be debated, there is broad agreement that the workforce is divided into three inter-related sectors – specialist, generalist and lived experience (Cleary, Thomas and Boyle 2020). This section is broadly structured into specialist, generalist and lived experience sections, although these categories are by no means definitive or mutually exclusive.

Specialist workers

Specialist workers provide mental health services directly and may include professionals with tertiary training in a mental health-related field. For the purpose of this section, the specialist workforce is considered to include psychiatrists, mental health nurses, psychologists and mental health occupational therapists.

Generalist workers

Generalist workers include other professionals who engage in mental health-related work or with people experiencing mental illness, but who may not have specialist training in mental health. Alternatively, generalist workers may include people in administrative or research roles that are vital to support the specialist workforce.

Lived experience workers

Lived experience workers, also called peer workers, are people who have themselves experienced mental illness or cared for someone who has, and can bring valuable insight into the caring experience. People with lived experience may also have specialist or generalist qualifications.

How many specialist mental health workers are employed in Australia?

Four maps of Australia showing the number and rate per 100,000 population of psychiatrists, mental health nurses, psychologists and mental health occupational therapists by state or territory, remoteness area, Primary Health Network (PHN) or Statistical Area 4 (SA4). The Australian Capital Territory has a substantially higher rate of psychologists than other jurisdictions (202.7). All four professions are found at the highest rate in Major cities across all states and territories, with the exception of mental health nurses, who are found at a higher rate in Inner Regional areas of New South Wales (99.3) than in Major cities in New South Wales (94.8). The PHN with the highest rate of psychiatrists is Brisbane North (25.9). The SA4 with the rightest rates of mental health occupational therapists are Perth – Inner (47.0) followed by Townsville (26.8).

Notes

  1. The number for each variable may not sum to the total due to the estimation process, rounding, not stated/missing data and/or confidentialisation.
  2. Crude rate is based on the Australian estimated resident population as at 30 June 2020 for State or territory, PHN and SA4, and 30 June 2016 for Remoteness area.

Mental health workers may be employed in a wide variety of settings, including state-run health services, private or not-for-profit care providers, and/or private practice. Each state and territory has a mental health workforce plan (Cleary, Thomas and Boyle 2020), intended to guide and support the development of the mental health workforce to ensure it meets the needs of residents. A 10-year national mental health workforce strategy is currently under development and expected to be released in 2022. For further information, refer to the National Mental Health Workforce Strategy Taskforce site.

Specialist workers

This section provides data on the number of psychiatrists, mental health nurses, psychologists and mental health occupational therapists who are employed in Australia. These professions are regulated by the Australian Health Practitioner Regulation Agency (AHPRA) and national boards, which enforces registration standards and legally protect these titles.

In 2020, there were 3,769 psychiatrists, 24,567 mental health nurses, 31,618 psychologists and 2,555 mental health occupational therapists working in Australia.

The total number of psychiatrists grew at an average annual rate of 3.8% from 2016 to 2020, compared to 3.6% for the whole medical profession. Notably, the number of psychiatrists aged 20–34 increased by a much higher rate of 26.9% (Males – 21.7%, Females – 33.4%) over this time period (Figure WK.2.1). Additionally, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) reported that 316 trainees had commenced their Fellowship program between February 2020 to February 2021, an increase of 52 from 2019. Just over half (54.0%) of trainees were aged 31 to 40 (RANZCP 2021a.

In 2020, the majority of psychiatrists (58.4%) were male, although the number of female psychiatrists has increased at more than double the average annual rate from 2016 to 2020 than male (6.1% and 2.3%, respectively). The other three professions were overwhelmingly female, comprising 71.0% of the mental health nurse workforce, 79.7% of the psychologist workforce and 84.9% of the mental health occupational therapist workforce (Figure WK.2.2).

Figure WK.2: Specialist mental health workers, number, by age group, sex, year, 2013–2020

Figure WK.2.1, a line chart showing the number of people working in each profession by sex and age group from 2013 to 2020. In 2020, the most numerous age group for psychiatrists was 45–54, mental health nurses 20–34, psychologists 35–44, mental health occupational therapists 20–34.

Figure WK.2.2, a horizontal butterfly bar chart showing the number of each profession in each age group by sex and year. In 2020, the largest group of psychiatrists are males aged 45–54 (667), mental health nurses, females aged 20–34 (4,614), psychologists females aged 35–44 (7,391), mental health occupational therapists females aged 20–34 (940).

Note: 1. The number for each variable may not sum to the total due to the estimation process, rounding, not stated/missing data and/or confidentialisation.

Source data: Mental health workforce tables 2020

The rate (per 100,000 population) of mental health nurses employed in Remote areas of the Northern Territory (125.6) was higher than those employed in Major cities in New South Wales (94.8) or Victoria (115.4). Overall though, all 4 professions tend to be concentrated in Major cities, with lower rates of workers per 100,000 population in Remote and Very remote areas (Figure WK.1). On average, workers in Remote and Very remote areas work more hours per week than their counterparts in Major cities.

According to the Psychology Board of Australia, 13,662 psychologists held an area of practice endorsement in 2020. The most common was Clinical psychology, accounting for 10,328, or 70.1%, of total endorsements (Psychology Board of Australia 2021a). More than two in five psychologists (42.1%) were employed in either solo or group private practice, while 1 in 10 are employed in schools.

The mental health occupation therapist workforce was the fastest growing of the four professions presented here, growing at an average annual rate of 7.3% from 2016 to 2020. This compares to 3.8% for psychiatrists, 3.3% for mental health nurses and 5.8% for psychologists.

Generalist workers

A large number of different professions and roles may be included under the broad category of generalist mental health workers. The availability of data varies considerably depending on the accreditation framework of each role. Selected examples are presented here:

Lived experience workers

Lived experience workers, also known as peer or consumer workers, are increasingly recognised as forming a vital component of mental health care. Lived experience workers also include informal carers – family members, friends or others who care for those experiencing mental illness outside of an employment or volunteer setting.

Expanding the lived experience workforce as a proportion of the overall mental health workforce is an indicator under The Fifth National Mental Health and Suicide Prevention Plan (DoH 2017). The National Mental Health Commission has released guidelines to support the development of a national lived experience workforce (Byrne et al. 2021).

Because of the broad scope and often informal nature of lived experience workers’ engagement with the mental health care sector, there are little reliable data on the total number of lived experience workers in Australia. An exception is specialised mental health care facilities. In 2019–20, 48.9% of these facilities employed consumer workers while 23.8% employed carer workers (AIHW 2022b). Nationally, 216.2 FTE paid consumer workers and 77.8 FTE paid carer workers were employed in these facilities (Productivity Commission 2022), though numbers varied greatly between states and territories (Figure WK.3). The number of consumer workers increased by an average of 15.9% per year from 2015–16 to 2019–20, while the number of carer workers increased by an average of 13.3% per year. For further information, refer to the Specialised mental health care facilities section.

Figure WK.3: Consumer and carer workers, FTE and rate, states and territories, 2010–11 to 2019–20

Line chart showing the Full Time Equivalent (FTE), rate per 1,000 paid direct care staff and rate per 100,000 population of consumer and career workers in each state and territory from 2010–11 to 2019–20. Queensland had the highest FTE of consumer and carer workers of any jurisdiction in 2019–20 (109.3). The Northern Territory has the highest rate of consumer workers per 100,000 population from 2017–18 (5.4) to 2019–20 (5.6). The Australian Capital Territory had the highest rate of carer workers in 2019–20 (0.6).

Note: 1. Crude rate is based on the Australian estimated resident population as at 30 June 2020.

Source data: Mental health workforce tables 2020

The Mental Health Commission of New South Wales also publishes some data on the peer and carer workforce engaged in that states’ mental health service system. In 2018, there were 100 FTE peer workers employed in NSW public mental health services (MHCNSW 2018).

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Key concepts

Key concept Description
Area of practice endorsement To qualify for an area of practice endorsement, a psychologist must have completed advanced training (a Masters or Doctorate qualification) in the particular area of practice followed by a period of supervised practice. There are nine endorsements, including clinical psychology and forensic psychology (APS 2022).
Clinical FTE Clinical FTE measures the number of standard-hour workloads worked by employed health professionals in a direct clinical role. Clinical FTE is calculated by the number of health professionals in a category multiplied by the average clinical hours worked by those employed in the category divided by the standard working week hours. The NHWDS considers a standard working week to be 38 hours for nurses, psychologists and occupational therapists and 40 hours for psychiatrists.
Clinical hours Clinical hours are the total clinical hours worked per week in the profession, including paid and unpaid work. The average weekly clinical hours is the average of the clinical hours reported by all employed professionals, not only those who define their principal area of work as clinician. Average clinical weekly hours are calculated only for those people who reported their clinical hours (those who did not report them are excluded).
Employed

In this report, an employed health professional is defined as one who:

  • worked for a total of 1 hour or more, principally in the relevant profession, for pay, commission, payment in kind or profit; mainly or only in a particular state or territory during a specified period, or
  • usually worked but was away on leave (with some pay) for less than 3 months, on strike or locked out, or rostered off.

This includes those involved in clinical and non-clinical roles, for example education, research, and administration. ‘Employed’ people are referred to as the ‘workforce’. This excludes those medical practitioners practising psychiatry as a second or third speciality, those who were on extended leave for 3 months or more and those who were not employed.
Full-time equivalent Full-time equivalent (FTE) measures the number of standard-hour workloads worked by employed health professionals. FTE is calculated by the number of health professionals in a category multiplied by the average hours worked by those employed in the category divided by the standard working week hours. In this report, a standard working week for nurses, psychologists and occupational therapists is assumed to be 38 hours and equivalent to 1 FTE. Like other medical practitioners, FTE measures for psychiatrists are based on a 40 hour standard working week.
Nurse

To qualify for registration as a registered or enrolled nurse in Australia, an individual must have completed an approved program of study (Nursing and Midwifery Board of Australia 2019). The usual minimum educational requirement for a registered nurse is a 3 year degree or equivalent. For enrolled nurses the usual minimum educational requirement is a 1 year diploma or equivalent.

For the purpose of this section, a mental health nurse is an enrolled or registered nurse that indicates their principal area of work is mental health. In other contexts, mental health nurse may refer to a nurse who has a specific qualification in mental health care instead of or as well as generalist care. Refer to the Nursing and Midwifery Board of Australia for more information.
Occupational therapist

Occupational therapists provide support to people whose health or disability impacts on their day-to-day life and function. For the purpose of this section, a mental health occupational therapist is an occupational therapist who has indicated they have a scope of practice of ‘mental health’.
Psychiatrist

A psychiatrist is a medical practitioner who has completed specialist training in the diagnosis, treatment and prevention of mental illness and emotional problems. Treatment may include prescribing medication, brain stimulation therapies and psychological treatment (RANZCP 2021b). To practice as a psychiatrist in Australia, an individual must be admitted as a Fellow of the Royal Australian & New Zealand College of Psychiatrists (RANZCP). Psychiatrists first train as a medical doctor, then undertake a medical internship followed by a minimum of 5 years specialist training in psychiatry (RANZCP 2020).
Psychologist

A psychologist is an allied health practitioner who is trained in human behaviour. They may provide diagnosis, assessment and treatment of mental illness through psychological interventions, such as cognitive behavioural therapy. The education and training requirement for general (full) registration as a psychologist is a 6 year sequence comprising a 4 year accredited sequence of study followed by an approved 2 year supervised practice program. The 2 year supervised practice program may be comprised of either an approved 2 year postgraduate qualification, a fifth year of study followed by a 1 year internship program or a 2 year internship program (Psychology Board of Australia 2021b).
Total hours

Total hours are the total hours worked per week in the profession, including paid and unpaid work. Average total weekly hours are calculated only for those people who reported their hours (that is, those who did not report them are excluded).