Community mental health care services

Mental illness is often treated in community and hospital-based outpatient care services provided by state and territory governments. Collectively, these services are referred to as  community mental health care (CMHC) services. State and territory health authorities collect a core set of information for the Community Mental Health Care National Minimum Data Set (CMHC NMDS), which is compiled annually into the National Community Mental Health Care Database (NCMHCD). Data from the NCMHCD are used to describe the care provided by these services. More information about the NCMHCD is available in the data source section.

Data downloads and links:

Community mental health care services 2019–20 tables (1.6MB XLSX)

Community mental health care services 2019–20 section (746KB PDF)

Data source information and key concepts related to this section.

Data coverage includes the time period 2005–06 to 2019–20. Data in this section was last updated in October 2021.

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Key points

  • Around 10 million community mental health care service contacts were provided to approximately 462,000 patients in 2019–20.
  • The most common principal diagnosis recorded for patients during a service contact was Schizophrenia (22.3%), followed by Depressive episode (6.7%) and Schizoaffective disorder (6.4%).
  • Involuntary contacts accounted for about 1 in 7 (14.7%) of all contacts.
  • The most frequently recorded type of community mental health care service contact was with an individual patient (as opposed to a group session). Most contact service had a duration of 5–15 minutes (39%).

Services provided

Around 10.0 million service contacts were provided by community mental health care services to over 462,000 patients in 2019–20. This equates to an average of 21.7 service contacts per patient.

The national average rate of patients receiving services was 18.1 patients per 1,000 population. The rate was highest in the Northern Territory (29.1) and lowest in Victoria (11.9) (Figure CMHC.1). Differences in jurisdictional data reporting systems may contribute to the observed variation in service contact rates.

Figure CMHC.1: Community mental health care patients, by states and territories, 2019–20

Interactive vertical bar chart showing the number of community mental health care patients, service contacts and treatment days as well as the rate of contacts and patients (rate per 1,000 population) for states and territories in 2019–20. New South Wales had the highest number of patients (138,088), followed by Queensland (107,844), Victoria (79,046), Western Australia (66,257), South Australia (42,817), the Australian Capital Territory (11,395), Tasmania (9,695) and the Northern Territory (7,113). The Northern Territory reported the highest rate (29.1 patients per 1,000 population) followed by the Australian Capital Territory (26.7), Western Australia (25.1), South Australia (24.3), Queensland (21.0), Tasmania (18.1), New South Wales (17.0), and Victoria (11.9). The national rate of community mental health care patients was 18.1 per 1,000 population (refer to Table CMHC.1).

Note: Community mental health care treatment days is only reported as a number.

Source data: Community mental health care services 2019–20 tables (1.6MB XLSX).

Changes over time

In 2005­–06, almost 5.7 million community mental health care service contacts took place across Australia. This has increased to around 10 million in 2019–20.

Across Australia in 2019–20 the rate of service contacts was 393.2 per 1,000 population and the rate of patients was 18.1. There was a decrease in both rates in 2016–17, when service contacts were at 365.2 per 1,000 population and patients were at 17.2. Despite this decrease, the national rate of both service contacts and patients per 1,000 population has remained relatively stable between 2015–16 and 2019–20 (392.4 to 393.2 for service contacts and 17.3 to 18.1 for patients). The average annual change for service contacts was unchanged over this time period while the average annual change for patients was 1.2%. The annual change over this time period varied across jurisdictions, with Tasmania reporting small decreases in the rate of both service contacts and patients (-1.5% and -1.2% respectively), New South Wales and South Australia reported decreases in service contacts (-4.0% and -1.5% respectively), and the Northern Territory reported a small decrease in patients (-0.7%).

The rate of service contacts in the Australian Capital Territory increased slightly between 2015–16 and 2019–20, and it had the highest rate of service contacts of any state or territory in 2019–20 (815.8 per 1,000 population). Tasmania had the lowest rate of service contacts in 2019–20 at 270.7 per 1,000 population.

Treatment periods

Four in 10 registered patients (39.7% or 183,591 people) had a length of treatment 92 days or more (the time between their first and last service contact during the reporting period) in 2019–20.

These patients received the highest proportion of treatment days (​81.0%) from community mental health care services (Figure CMHC.2).

Figure CMHC.2: Patients and total treatment days, by length of treatment period, 2019–20

Stacked vertical bar chart showing length of treatment period and the proportion of patients that received different lengths of treatment. 37.0% of patients received very brief treatment (1–14 days), 23.3% received short term treatment (15–91 days) and 39.7% received medium to longer term treatment (92+ days). 6.0% of reported treatment days were very brief, 13.0% were short term treatment and 81.0% were medium to longer term treatment (refer to table CMHC.25).

Source data: Community mental health care services 2019–20 tables (1.6MB XLSX).

Patient characteristics

In 2019–20, a similar proportion of community mental health care patients were males or females (48.9% and 51.1% respectively). However, males accessed services at a slightly higher rate than females (399.6 and 375.7 per 1,000 population respectively). People aged 12–17 years accounted for the highest rate of both community mental health care patients (33.8 per 1,000 population) and community mental health care service contacts (673.5 per 1,000 population), with females accounting for a higher rate of service contacts than males: 881.2 and 473.0 respectively.

People living in Major cities made up the majority of community mental health care patients (63.3%) and people living in Very remote areas made up the smallest proportion at 1.6%. However, the population adjusted rate per 1,000 population was highest for people living in Very remote areas (36.3) and people living in Major cities has the lowest rate per 1,000 population (15.6).

Aboriginal and Torres Strait Islander patients comprised 10.8% of community mental health care patients in 2019–20, however the rate of Indigenous patients per 1,000 population was more than 3 times the rate of non‑Indigenous patients (56.8 compared to 16.1) (Figure CMHC.3).

Figure CMHC.3: Community mental health care patients, by key demographics, 2005–06 to 2019–20

Two interactive charts. A horizontal bar chart showing the rate (per 1,000 population), per cent or number of community mental health care patients by demographic variables of age, sex, Indigenous status, remoteness area and SEIFA quintile in 2019–20. The lowest rate for patients by age was seen for those aged 0–4 years (1.7 people per 1,000 age specific population) and the highest rate was for patients aged 12–17 years (33.8).  Male and female patients had similar rates per 1,000 population (17.8 and 18.3 respectively). The highest rate of patients per 1,000 population by remoteness area was seen for patients living in Very remote areas (36.3), followed by Remote (33.5), Outer regional (25.9), Inner regional (21.3), and lowest for Major cities (15.6). The rate of patients per 1,000 population living in SEIFA Quintile 1 (most disadvantaged) was the highest of all quintiles (23.1), which decreased to 11.9 for Quintile 5 (least disadvantaged) (refer to Table CMHC.9). 2nd figure is a time series of the first chart from 2005–06 to 2019–20 (refer to Table CMHC.8).

Note: Age-standardised rate is shown for Indigenous Status.

Source data: Community mental health care services 2019–20 tables (1.6MB XLSX).

Principal diagnosis

In 2019–20, Schizophrenia was the most frequently recorded mental health related principal diagnosis for community mental health service contacts (22.3%), followed by Depressive episode (6.7%), Schizoaffective disorders (6.4%) Bipolar affective disorders (5.3%), Reaction to severe stress and adjustment disorders (5.2%) and Specific personality disorders (5.1%). A principal diagnosis was reported for 8 out of 10 (8.3 million) community mental health care service contacts.

There is variation however across the different age groups when looking at the most frequently recorded principal diagnosis for community mental health service contacts (Figure CMHC.4). Younger age groups (those aged up to 24 years) most frequently recorded Mental disorder not otherwise specified, while those aged 25–74 years most frequently recorded Schizophrenia.

Figure CMHC.4: Community mental health care service contacts, for six of the most commonly reported mental health-related principal diagnoses, by age group, 2019–20

Interactive horizontal bar chart showing 6 of the most commonly reported specific principal diagnosis for community mental health care service contacts in 2019–20 by age group. The most frequently reported principal diagnosis for those aged 0-4 years, 5-11 years, 12-17 years and 18-24 years was Mental disorder not otherwise specified (23.6%, 23.0%, 22.1% and 24.9% respectively). For older ages, Schizophrenia was the most frequently reported principal diagnosis, ranging from 20.3% for those aged 65-74 years to 33.8% for those aged 33.8%) (refer to Table CMHC.18).

Source data: Community mental health care services 2019–20 tables (1.6MB XLSX).

Characteristics of service contacts

Community mental health care service contacts can be conducted as either individual or group sessions. Service contacts can also be face-to-face, via telephone, or using other forms of direct communication such as video link. They can be conducted in the presence of the patient, with a third party, such as a carer or family member, and/or other professional or mental health worker.

The majority of service contacts reported in 2019–20 involved individual contact sessions (95.4%) and 4.6% of contacts were group sessions. More than half of all contacts were individual sessions (52.1%), where the patient participated in the service contact (termed patient present).

Target population

Services targeted toward the General population made up 69.6% of all treatment days in 2019–20 followed by Child and adolescent (15.0%), Older person (7.1%), Forensic (6.6%), and Youth services (1.7%). Services targeted towards Forensic, Older person, and Youth populations accounted for much smaller proportions of treatment days than the General population and Child and adolescent services. These results largely mirror the relative size (as measured by the number of full-time-equivalent staff) for each of the community mental health care service target population categories at (Specialised mental health care facilities section, Table FAC.41).

Duration of service contacts

The duration of community mental health care service contacts ranges from less than 5 minutes to over 3 hours. In 2019–20, the average service contact duration of sessions was 34 minutes. Nearly 4 in 10 contacts were 5–15 minutes in duration (38.9%, or 3.9 million) and almost 1 in 4 contacts were 16–30 minutes in duration (24.6%, or 2.5 million) (Figure CMHC.5). Service contacts with the patient present were on average twice as long in duration than service contacts where the patient was absent (average 44 and 22 minutes respectively).

Of the 5 most commonly reported principal diagnoses (Schizophrenia, Depressive episode, Bipolar affective disorders, Reaction to severe stress and adjustment disorders, and Schizoaffective disorders), Reaction to severe stress and adjustment disorders had the highest proportion of contacts lasting over 1 hour (13.6%).

Figure CMHC.5: Community mental health care service contacts, by session duration, 2005–06 to 2019–20

Two interactive charts, A stacked horizontal bar chart showing the duration of community mental health care service contacts by session duration and patient participation status in 2019–20. The most frequent contact duration was 5–15 minutes (38.9%), followed by 16-30 minutes (24.6%), >0.5-1 hour (19.9%), >1-3 hours (10.9%), <5 minutes (4.9%), and >3 hours (0.7%). 54% of contacts occurred with the patient present (5.4 million) and 46% occurred with the patient absent (4.6 million). Contacts lasting more than 3 hours were more likely to occur with the patient present than without the patient (1.2% and 0.2% respectively), while contacts lasting 5 minutes or less were more likely to occur without the patient than with the patient (10.0% and 0.5% respectively) (refer to Table CMHC.22). 2nd figure is a time series of the first chart from 2005–06 to 2019–20 (refer to Table CMHC.24).

Source data: Community mental health care services 2019–20 tables (1.6MB XLSX).

Mental health legal status

About 1 in 7 (14.7%, 1,429,488) community mental health care service contacts in 2019–20 involved a patient with an involuntary mental health legal status. Western Australia reported the lowest proportion of involuntary contacts (3.1%), while Queensland reported the highest (25.3%). These differences most likely reflect the different legislative arrangements in place amongst the jurisdictions. More information can be found in the CMHC NMDS Data Quality Statement.

In 2019–20, of the 5 most commonly reported principal diagnoses, the highest proportion of contacts involving a patient with an involuntary mental health legal status was seen for patients diagnosed with Schizoaffective disorders (39.2% involuntary), followed by Schizophrenia (35.0%), Bipolar affective disorder (21.7%), Depressive episode (2.8%), and Reaction to severe stress and adjustment disorders (2.4%) (Figure CMHC.6).

Figure CMHC.6: Community mental health care service contacts by mental health legal status, 2019–20

A story board of two interactive charts. The first chart is a horizontal bar chart comparing the number and proportion of voluntary and involuntary contacts for 5 of the most commonly reported principal diagnoses in 2019–20. Schizoaffective disorders (60.8% voluntary and 39.2% involuntary); Schizophrenia (65.0% voluntary and 35.0% involuntary); Bipolar affective disorders (78.3% voluntary and 21.7% involuntary); Depressive episode (97.2% voluntary and 2.8% involuntary); Reaction to severe stress and adjustment disorders (97.6% voluntary and 2.4% involuntary) (refer to Table CMHC.28). The second is a time series stacked vertical bar chart showing community mental health care service contacts by mental health legal status and by state and territory (refer to Table CMHC.27).