In a calendar year, 1 in 5 (21%) people aged 16–85 will experience mental illness (ABS 2022). Mental illness can affect not just the individual, but also their family, friends and the community – in 2018, Mental and substance use disorders were responsible for around 13% of the total disease burden in Australia (AIHW 2021).
People with mental illness can access a variety of support services, which are delivered by governments, and by the private and not-for-profit sectors.
Mental health treatment, care and support is provided in a range of settings and services, including:
- specialised hospital services – public and private
- residential mental health services
- community mental health care services
- primary care services.
Health care professionals who provide treatment, care and support within the mental health system include:
- general practitioners
- psychiatrists and other medical staff
- psychologists
- nurses – registered and enrolled
- social workers
- other allied health professionals
- mental health consumer and carer workers
- other personal care staff.
A large number of support services are provided to people with a mental illness each year. For example, state and territory community mental health care services provided around 10 million service contacts in 2020–21 (Table 1).
Table 1: Selected mental health-related services provided, 2019–20 to 2020–21
| Service type |
Volume |
Selected findings |
|
Medicare-subsidised mental health-related services(a)
|
14.0 million services in 2020–21
|
Psychologists (including Clinical Psychologists) (48%) were the largest providers of these services.
26% of services were delivered via telehealth.
|
|
People accessing Medicare-subsidised mental health-related services
|
2.9 million people in 2020–21
|
11% of Australians accessed these services, up from 7% in 2010–11.
|
|
Mental health-related prescriptions(b)
|
42.7 million prescriptions in 2020–21
|
4.5 million patients (18% of the Australian population) received these prescriptions.
73% of prescriptions were for antidepressant medication(b).
|
|
Public sector community mental health care service contacts
|
10.2 million contacts in 2020–21
|
Aboriginal and Torres Strait Islander patients received community mental health care services at more than 3 times the rate of non-Indigenous patients.
|
|
Emergency department (ED) services (public hospitals)
|
309,657 presentations in 2020–21
|
309,657 presentations to public Australian EDs were mental health-related, which was 4% of all presentations (up from 3% in 2011–12).
|
|
Overnight admitted patient hospitalisations
|
275,270 hospitalisations in 2019–20
|
Depressive episode (15%) and Schizophrenia (13%) were the most common principal diagnoses for overnight mental health-related hospitalisations with specialised psychiatric care.
|
|
Same-day admitted patient hospitalisations
|
59,002 hospitalisations in 2019–20
|
Almost 1 in 4 (22%) of same day, admitted mental health-related hospitalisations with specialised psychiatric care in public hospitals had a principal diagnosis of Depressive episode.
|
- Includes psychiatrists, GPs, clinical psychologists, other psychologists and other allied health services. These services are billed as mental health-related items, which underestimates the total mental health-related activity, especially for services provided by GPs.
- Prescriptions subsidised and under co-payment under the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme.
Source: AIHW 2022 MHSA.
About $11.0 billion, or $431 per person, was spent on mental health-related services in Australia in 2019–20; $10.4 billion of this was government mental health expenditure, representing 7.6% of total government health expenditure. Per person, total spending on mental health increased (in real terms) by an annual average of 1.3% between 2015–16 and 2019–20. The total expenditure in 2019–20 included:
- about $6.7 billion, or $260 per person, spent on state and territory specialised mental health services
- about $1.4 billion, or $53 per person, spent on Medicare Benefits Scheme (MBS) subsidised services
- about $566 million, or $22 per person, spent on mental health-related prescriptions subsidised under the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS).
Comparing 2015–16 with 2019–20, recurrent per person spending on state and territory specialised mental health services increased (in real terms) from $250 to $260.
See Expenditure on mental health services for more information.
A variety of professionals deliver care and support to people with mental illness, including psychologists, psychiatrists, mental health nurses, general practitioners (GPs), social workers, counsellors and peer workers. Available registered and employed workforce data for some of these professions indicate that in Australia in 2020 there were:
- 31,618 psychologists
- 24,567 mental health nurses
- 3,769 psychiatrists
- 2,555 mental health occupational therapists.
In 2019–20, there were about 35,686 full-time equivalent (FTE) staff employed in state and territory specialised mental health care services.
See Mental health workforce for more information.
Safety and quality is important in all areas of the health system. A safe and high-quality health system provides the most appropriate and best-value care, while keeping patients safe from preventable harm. Data are available that can be used to measure aspects of safety and quality in the Australian mental health care system – including use of restrictive practices, consumer perspectives of care, and change in mental health consumers’ clinical outcomes.
Seclusion and restraint
Use of seclusion and restraint are examples of restrictive practices and are included in the Key Performance Indicators for Australian Public Mental Health Services (NMHPC). Seclusion is defined as the confinement of a patient alone in a room or area from which free exit is prevented. Restraint is defined as the restriction of an individual's freedom of movement by physical or mechanical means.
Reducing, and where possible, eliminating the use of seclusion and restraint is a policy priority in Australian mental health care and has been supported by changes to legislation, policy and clinical practice (RANZCP 2021).
Seclusion events in specialised acute public hospital mental health services over the past decade have fallen from 13.9 seclusion events per 1,000 bed days in 2009–10 to 7.3 events per 1,000 bed days in 2020–21 (Figure 1).
Mechanical restraint events fell from 1.7 events per 1,000 bed days of patient care in 2015–16 to 0.7 in 2020–21. The use of physical restraint has remained relatively stable, since reporting began in 2015–16, varying between 10 to 12 events per 1,000 bed days of patient care.