Overnight admitted mental health-related care

Some people’s mental health care needs may require care in a hospital setting such as a hospital ward, an emergency department or an outpatient clinic. A patient may be admitted to the hospital just for the day, a single overnight stay, or for a number of days. Care that lasts more than one day is referred to as overnight admitted patient care.

When admitted to a hospital, patients can receive specialised psychiatric care in a psychiatric hospital or in a hospital’s psychiatric unit. Patients with mental illness may also be admitted overnight to other areas of the hospital where health care workers may not be specifically trained to care for the mentally ill, such as a drug and alcohol treatment unit. These overnight admissions are classified as being without specialised psychiatric care.

This section presents information on overnight admitted patient mental health-related hospitalisations from Australian hospitals. Further information can be found in the data source section.

Data downloads:

Overnight admitted mental health-related care 2019–20 tables (148KB XLSX)

Overnight admitted mental health-related care 2019–20 section (1.1MB PDF)

Data source and key concepts

Data coverage includes the time period 2006–07 to 2019–20. This section was last updated in May 2022.

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Key points

  • 275,270 overnight admitted mental health-related hospitalisations occurred in 2019–20, of which 62.7% included specialised psychiatric care.
  • Depressive episode (15.4%) and Schizophrenia (13.4%) were the most common diagnoses for overnight mental health-related hospitalisations with specialised psychiatric care.
  • Aboriginal and Torres Strait Islander patient rates[1] of overnight mental health-related hospitalisations with and without specialised care were 2.4 and 2.5 times the rates for non-Indigenous patients.
  • Over the past decade, the overnight mental health-related hospitalisations per 10,000 population increased by 2.1% on average annually.
  • For females aged 12–17, the rate of overnight hospitalisations with specialised care per 10,000 population has more than doubled between 2006–07 (37.3) and 2019–20 (78.1). The rate of hospitalisation for males of this age group also increased over this time, from 18.3 per 10,000 population to 31.6.
  • For those aged 85+, the rate of overnight mental health-related hospitalisations without specialised care per 10,000 population has increased by 85% between 2006–07 and 2019–20.
  • For 12–17 year old females, the rate of overnight mental health-related hospitalisations with specialised psychiatric care per 10,000 population has been about 2 to 3 times the rate for males between 2006–07 and 2019–20.

(1)Age standardised rates are calculated for the Indigenous-based analysis.

There were almost 4.3 million overnight admitted hospitalisations in 2019–20 across both public and private sectors. Of these, 275,270 were mental health-related, representing about 1 in 15 (6.4%) of all overnight hospitalisations. Almost two-thirds of these involved specialised psychiatric care (172,641 or 62.7%) and more than 3 in 4 occurred in public hospitals (78.6%).

Long-term trends show steady increases in the rates (per 10,000 population) of overnight mental health‑related hospitalisations and patient days, both with and without specialised psychiatric care.

Specialised overnight admitted patient mental health care

Specialised overnight admitted patient mental health care (also referred to as specialised psychiatric care) takes place within a designated psychiatric ward/unit, which is staffed by health professionals with specialist mental health qualifications or training and have as their principal function the treatment and care of patients affected by mental illness.

Figure ON.1: Overnight mental health-related hospitalisations, patient days, psychiatric care days and procedures with specialised psychiatric care, states and territories, by hospital type, 2019–20

Alt text: Figure ON.1.1, stacked bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related patient days, psychiatric care days and procedures with specialised psychiatric care for all states and territories by type of hospital in 2019–20. In public psychiatric hospitals, Tasmania had the highest rate of patient days at 640.6 per 10,000 population. In public acute hospitals; the Australian Capital Territory had the highest rate of patient days at 935.0 per 10,000 population. Refer to table ON.5.
Figure ON.1.2, a line chart showing the number of overnight admitted mental-health related hospitalisations and procedures with specialised psychiatric care by type of hospital from 2006–07 to 2019–20. In private hospitals there were 49,771 hospitalisations and 196,374 procedures in 2019–20. In public psychiatric hospitals there were 10,177 hospitalisations and 23,306 procedures in 2019–20. In public acute hospitals there were 112,693 hospitalisations and 230,364 procedures in 2019–20. Refer to table ON.3

Notes:
1. The Australian Capital Territory and Northern Territory do not have any public psychiatric hospitals.
2. Private hospital figures for Northern Territory are not published for confidentiality reasons.

Source data: Overnight admitted mental health-related care 2019–20 tables (148KB XLSX), table ON.5, table ON.3.

Length of stay and mode of separation

In 2019–20, the national average length of stay for overnight mental health-related hospitalisations in public acute hospitals was 15.3 days, which is similar to the 2018–19 figure (15.1 days). Please refer to the data source for information on patient day fluctuations over time. New South Wales had the longest average length of stay (18.1 days) and the Northern Territory the shortest (11.9 days). The average length of stay in public psychiatric hospitals ranged between 35.1 days in South Australia to 246.6 days in Queensland.

Patient demographics

In 2019–20, the rate of overnight mental health-related hospitalisations with specialised psychiatric care was highest for patients aged 18–24 years and 35–44 years (108.1 and 104.3 per 10,000 population respectively) and lowest for those aged 0–11 years (1.4 per 10,000 population) (Figure ON.2.1). Overall, the rate was higher for females than males (70.0 and 65.0 per 10,000 population respectively), but there is variation across individual age groups.

There were 13,039 overnight mental health-related hospitalisations with specialised psychiatric care for Indigenous Australians in 2019–20, or 154.2 per 10,000 population, which is 2.4 times higher than the rate for non-indigenous patients (63.5). Age standardised rates were 169.6 and 62.8 per 10,000 population respectively, so the standardised rate for Indigenous people was 2.7 times that of other patients.

Patients living in Major cities and Inner regional areas had the highest rate of overnight mental health-related hospitalisations with specialised psychiatric care in 2019–20 (66.9 and 67.5 per 10,000 population respectively), whilst those living in Remote and Very remote areas had the lowest (42.0).

Figure ON.2: Overnight mental health-related hospitalisations with specialised psychiatric care, by demographics, 2019–20

Alt text: Figure ON.2.1, a horizontal bar chart showing the per cent and rate (per 10,000 population) of overnight admitted mental health-related hospitalisations with specialised psychiatric care by age group, sex, Indigenous status, remoteness and SEIFA quintiles in 2019–20. The figure reports age group by 0–11 years, 12–17 years, 18–24 years, 25–34 years, 35–44 years, 45–54 years, 55–64 years, 65–74 years, 75–84 years, and 85 years and older. Sex is reported for males and females, Indigenous status is reported by Indigenous Australians and Non-Indigenous Australians, remoteness is reported by people living in Major cities, Inner regional, Outer regional, and Remote and very remote and SEIFA quintiles are reported from 1 (most disadvantaged) to Quintile 5 (least disadvantaged). Refer to Table ON.6.
Figure ON.2.2, a vertical stacked bar chart showing the rate (per 10,000) of overnight admitted mental health-related hospitalisations with specialised psychiatric care, by age and sex from 2006–07 to 2019–20. In 2019–20, there were 1.6 and 1.2 hospitalisations  per 10,000 population for males and females, respectively, aged 0–11 years with specialised psychiatric care; 31.6, 78.1 for 12–17 years, 92.3, 124.4 for 18–24 years, 97.8, 94.6 for 25–34 years, 112.1, 96.5 for 35–44 years, 93.7, 93.0 for 45–54 years, 59.2, 63.7 for 55–64 years, 40.9, 47.9 for 65–74 years, 29.3, 38.5 for 75–84 years, and 21.5, 25.6 for 85 years and older. Refer to table ON.4.

Figure ON.3: Proportion of overnight mental health-related hospitalisations with specialised psychiatric care, for 5 commonly reported principal diagnoses, by hospital type, 2019–20

Alt text: Figure ON.3.1, a horizontal bar chart showing the per cent of overnight admitted mental health-related hospitalisations with specialised psychiatric care for 5 of the most frequently reported principal diagnoses by private, public psychiatric and public acute hospital types in 2019–20. Depressive episode (ICD-10-AM code F32) was the principal diagnosis for 27.5% of hospitalisations in private hospitals; Schizophrenia (F20) accounted for 2.0% private; Reaction to severe stress and adjustment disorders (F43) accounted for 11.6% private; Bipolar affective disorders (F31) accounted for 10.7% private; Mental and behavioural disorders due to other psychoactive substance use (F11–19) accounted for 5.5% private. Refer to Table ON.7.
Figure ON.3.2, a horizontal bar chart showing the per cent of overnight admitted mental health-related hospitalisations with specialised psychiatric care for 5 of the most commonly reported procedure blocks in 2019–20. 58.9% of hospitalisations included a procedure block of Generalised allied health interventions, 19.0% Psychological/psychosocial therapies, 13.4% Other reported procedures, 8.7% Assessment of personal care and other activities of daily/independent living and 8.2% Mental, behavioural or psychosocial assessment. Refer to table ON.10.

Source data: Overnight admitted mental health-related care 2019–20 tables (148KB XLSX), table ON.7, table ON.10.

Non-specialised overnight admitted patient mental health care

Non-specialised admitted patient mental health care takes place in hospital but outside a designated psychiatric unit but for which the principal diagnosis is considered to be mental health-related.

A list of mental health-related principal diagnoses is available in the technical information section. Data for public acute and public psychiatric hospitals are combined, as there were very few hospitalisations without specialised psychiatric care in public psychiatric hospitals in 2019–20.

Figure ON.4: Overnight mental health-related hospitalisations, patient days and procedures without specialised psychiatric care, state and territories, by hospital type, 2019–20

Alt text: Figure ON.4.1, a stacked bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related patient days and procedures without specialised psychiatric care in private and public hospitals for state and territories in 2019–20. In public hospitals, the Northern Territory had the highest rate of patient days at 329.4 per 10,000 population. In private hospitals, Queensland had the highest rate of patient days at 57.1 per 10,000 population Refer to Table ON.5.
Figure ON.4.2, a line chart showing the number of overnight admitted mental-health related hospitalisations and procedures without specialised psychiatric care by type of hospital from 2006–07 to 2019–20. In private hospitals there were 9,231 hospitalisations and 24,345 procedures in 2019–20. In public hospitals there were 93,398 hospitalisations and 182,780 procedures in 2019–20. Refer to table ON.3.

Source data: Overnight admitted mental health-related care 2019–20 tables (148KB XLSX), table ON.5, table ON.3.

Patient demographics

In 2019–20, the highest rate of overnight mental health-related hospitalisations without specialised psychiatric care was for patients aged 85 and older (297.0 per 10,000 population) and the lowest for those aged 0–11 (11.7). The rate was slightly higher for females than males (41.5 and 38.7 respectively) (Figure ON.5.1), but there is variation across individual age groups. Females had higher rates for age groups 12–17 years, 18–24 years, and 25–34 years, while males had higher rates for all other age groups.

There were 7,980 overnight mental health-related hospitalisations without specialised psychiatric care for Indigenous Australians in 2019–20, or 94.4 per 10,000 population, which is 2.5 times higher than the rate of 38.1 for other patients. Age standardised rates were 115.1 and 31.5 respectively, so the standardised rate for Indigenous people was 3.7 times that of other patients.

People living in Remote and Very remote areas had the highest rate of overnight mental health-related hospitalisations without specialised psychiatric care in 2019–20 and those living in Major cities had the lowest rate (77.8 and 37.5 respectively).

People living in the most disadvantaged socioeconomic quintile (SEIFA Quintile 1) had the highest rate of overnight mental health-related hospitalisations without specialised psychiatric care at 44.8 per 10,000 people. Those living in the least disadvantaged quintile (SEIFA Quintile 5) had the lowest rate of 34.1.

Figure ON.5: Overnight mental health-related hospitalisations without specialised psychiatric care, by demographics, 2019–20

Figure ON.5.1, a horizontal bar chart showing the per cent and rate (per 10,000 population) of overnight admitted mental health-related hospitalisations without specialised psychiatric care by age group, sex, Indigenous status, remoteness and SEIFA quintiles in 2019–20. There were 38.7 hospitalisations per 10,000 population for males and 41.5 for females; 115.1 for Indigenous Australians and 31.5 for Non-Indigenous Australians; 37.5 for persons living in Major cities, 38.5 for Inner regional, 49.2 for Outer regional and 77.8 for Remote and Very remote. SEIFA Quintile hospitalisations ranged from 44.8 for quintile 1 (most disadvantaged) to 34.1 for quintile 5 (least disadvanataged). Refer to Table ON.6.
Figure ON.5.2, a stacked horizontal bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related hospitalisations without specialised psychiatric care by age group and sex from 2006–07 to 2019–20. In 2019–20, there were 12.5 and 10.8 hospitalisations per 10,000 population for males and females aged 0–11 years without specialised psychiatric care; 10.5, 36.0 for 12–17 years, 21.6, 35.4 for 18–24 years, 28.4, 38.6 for 25–34 years, 40.2, 39.1 for 35–44 years, 40.5, 32.1 for 45–54 years, 34.1, 24.7 for 55–64 years, 45.7, 36.7 for 65–74 years, 130.1, 114.2 for 75–84 years, and 321.7, 281.6 for 85 years and older. Refer to table ON.4.

Figure ON.6: Proportion of overnight mental health-related hospitalisations without specialised psychiatric care, for 5 commonly reported principal diagnoses, by hospital type, 2019–20

Figure ON.6.1, a horizontal bar chart showing the per cent of overnight admitted mental health-related hospitalisations without specialised psychiatric care for 5 of the most frequently reported principal diagnoses in private and public hospitals. In 2019–20, 23.8% of hospitalisations  without specialised psychiatric care in private hospitals occurred for people with a principal diagnosis of Mental and behavioural disorders due to use of alcohol (F10); Other organic mental disorders (F04–09), 21.4%; Dementia (F00–03), 9.4%; Mental and behavioural disorders due to other psychoactive substance use (F11-19), 5.8%; Depressive episode (F32), 5.4%. Refer to Table ON.7.
Figure ON.6.2, a horizontal bar chart showing the per cent of overnight admitted mental health-related hospitalisations without specialised psychiatric care for 5 of the most commonly reported procedure blocks in 2019–20. 55.6% of hospitalisations included a procedure block of Generalised allied health interventions, 12.5% Other reported procedures, 8.8% Alcohol and drug rehabilitation and detoxification, 8.0% Assessment of personal care and other activities of daily/independent living and 6.8% Mental, behavioural or psychosocial assessment. Refer to Table ON.10.

Source data: Overnight admitted mental health-related care 2019–20 tables (148KB XLSX), table ON.7, table ON.10.

Regional reporting

Information on overnight mental health-related hospitalisations is reportable at smaller geographic areas than state and territory boundaries. Sub-jurisdictional reporting provides the opportunity to consider differences within jurisdictions. For the analysis presented here, the geographical area is based on the usual residence of the patient rather than the geographical location of the hospital. There are 2 types of geographical areas which are reported here:

  • Primary Health Network (PHN) areas – 31 geographic areas covering Australia, with boundaries defined by the Australian Government Department of Health.
  • Statistical Areas Level 3 (SA3s) – 333 geographic areas covering Australia, with boundaries defined by the Australian Bureau of Statistics.

In 2019–20, the national rate of mental health-related hospitalisations was 107.7 per 10,000 population. At the PHN level, Western Queensland (PHN code 305) had the highest rate (156.3) and Western Sydney (PHN code 103) had the lowest (82.5).

The observed variability in hospitalisation rates between geographical areas may be due to a range of factors including the proportion of the population in an area with a diagnosable mental illness who are admitted to hospital, availability of community-based services and variability in approaches to planning and delivering mental health support services across and within states and territories.