Mental health treatment and support services have an important role in the recovery of people with mental health issues. This section presents information about the mental health-related problems faced by consumers of public sector specialised mental health services and whether consumers improve after receiving mental health care, as measured by a set of clinically-derived indicators.
Data are available in this section about consumers of public sector specialised mental health services. There is a range of other mental health services not included here—for example, clinical measures may be collected to aid consumers’ recovery in private hospitals, private clinicians’ practices, non-government organisations, primary health care networks, and other services. However, outcomes data from those services are not routinely collected under national agreements and thus are not available for reporting.
Clinical measures are particular surveys or forms that are used to gather information about a person's clinical mental health status and functioning. Measures can be completed by clinicians about the consumer (known as clinician-rated), completed by the consumer (consumer-rated), and completed by families and carers about the consumer (carer-rated). When the same clinical measures are completed more than once, they can be used to determine whether a person shows improvement, no change, or deterioration from mental health care.
Data reported in this section are gathered under the National Outcomes and Casemix Collection (NOCC), first specified in 2003 to guide states and territories in the implementation of routine consumer outcomes measurement in public mental health services in Australia. All consumers who receive clinical care in public sector specialised mental health services should be included in the NOCC, including psychiatric inpatient, residential and ambulatory (non-admitted) service settings. More information about the NOCC is in the data source section.
This section provides an overview of the NOCC and key findings. More detailed data are available via the National Outcomes and Casemix Collection Web Decision Support Tool and Reports Portal.
Data downloads:
Consumer outcomes in mental health care 2018–19 tables (259KB XLSX)
Consumer outcomes in mental health care 2018–19 section (1.2MB PDF)
Data source information and key concepts related to this section.
Data coverage includes the time period 2014–15 to 2018–19. This section is new, and was first released on MHSA in July 2021.
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Key points
- Information was recorded in the NOCC for 196,045 people in 2018–19, which covers 42.7% of consumers of public mental health services.
- In 2018–19 for consumers aged 11–17, the most common clinically significant problems were emotions, family and peer relationships; for adults aged 18 and over these were depressed mood and comorbid mental/behavioural problems; and for people aged 65 and over physical health problems/disability were also common.
- In 2018–19 clinician-rated measures were completed at much higher rates than consumer-rated measures across all age bands.
- In 2018–19, most consumer episodes involving discharge from inpatient care showed improvement on clinicians’ ratings, at 54.4% (aged 11–17), 73.8% (aged 18–64) and 72.6% (65 and older) of episodes; consumers in this setting showed deterioration in up to 9.9% of episodes across these age bands.
- In 2018–19, around half of consumer episodes involving discharge from ambulatory (non-admitted) care showed improvement on clinicians’ ratings, at 52.6% (aged 11–17), 51.2% (aged 18–64), and 48.4% (65 and older) of episodes; consumers in this setting showed deterioration in up to 6.5% of episodes across these age bands.
- In 2018–19, a higher proportion of consumer episodes involving ongoing ambulatory care showed no change on clinicians’ ratings, at 46.1% (aged 11–17), 56.6% (aged 18–64) and 60.0% (65 and older) of episodes; consumers in this setting showed deterioration in up to 18.1% of episodes across these settings.
What are outcomes and casemix?
The NOCC collects information about a consumer's clinical mental health status and functioning during their mental health care. Measures completed by clinicians about the consumer (known as clinician-rated) and measures completed by the consumer (consumer-rated) are used. These measures are completed at multiple collection occasions during an episode of care to monitor changes in consumers' clinical status and functioning.
Ratings information is used to report on consumers’ outcomes of care—that is, whether consumers of mental health services show improvement, no change, or deterioration from receiving mental health care. Clinical outcomes such as these are just one aspect of a consumer’s recovery.
In addition to outcomes, data items in the NOCC gather information about other factors that together are known as casemix. In this section, casemix items include the consumers’ mental health legal status, diagnoses and phase of care—for example, whether care focuses on assessment, active short-phase treatment (acute care), or to improve personal, social or occupational functioning (gain).
The collection of the NOCC measures is guided by a set of rules on what measures to collect and when to collect them. More information is in the data source section and more detailed information is in the technical specifications.
Confidence intervals
This section reports confidence intervals in the data tables and visualisations. A confidence interval is a range of values that quantifies the uncertainty in estimates that result from natural or random variation. For example, in the number of services provided and the number of persons using services over time. There are also non-random sources of uncertainty, such as incomplete reporting, that are not captured by confidence intervals.
Generally, confidence intervals describe how different an estimate could have been if the underlying conditions stayed the same but random fluctuations had led to a different set of data. Accordingly, it is recommended that confidence intervals are reported alongside a number estimate.
Confidence intervals are calculated with a stated probability (commonly 95%); this means we can be 95% confident that the confidence interval includes the true value if the assumptions made in the construction of the confidence interval hold. Larger numbers of observations yield more precise estimates with narrower confidence intervals. Confidence intervals can be used to perform tests of statistical significance. If the 95% confidence intervals do not overlap—that is, they do not include the same values in the range—the difference can be said to be statistically significant (note that differences can be significant in a subset of cases where the ranges do overlap).
In this section, 95% confidence intervals are shown in all figures and tables.
Further information about confidence intervals, including calculation methods, statistical assumptions behind the calculation and sources of variability can be found in the data source section.
Consumers included in the NOCC
Coverage
All consumers who receive clinical care in public sector specialised mental health services—including psychiatric inpatient, residential and ambulatory (non-admitted) services—should be included in the NOCC.
Nationally, in 2018–19, NOCC measures were collected for 196,045 people, which is 42.7% of the 458,820 people who received clinical care from public sector specialised mental health services (Table NOCC.1).
The proportions of people who received clinical care in public sector specialised mental health services who were included in the NOCC were highest among people aged 75–84 (47.3%) and 85 years and over (46.3%) and lowest among people aged 0–17 and 18–24 (41.1%) and 25–34 years (42.1%) (Table NOCC.2).
Demographics
In 2018–19, 49.9% of the consumers included in the NOCC were male and 50.0% were female. There were 68,909 people aged between 25 and 44 years, accounting for 35.1%. There were 17,693 Aboriginal and Torres Strait Islander peoples, accounting for 9.3%.
People living in Major cities made up the majority of consumers included in the NOCC (65.4%) and people living in Very remote areas made up the smallest proportion (1.4%). People living in areas of most socio-economic disadvantage made up the largest proportion at 25.3%, while people living in areas of least disadvantage made up the smallest at 14.6% (Figure NOCC.1).