Characteristics of service contacts

Type of service contacts

Community mental health care service contacts can be conducted either individually or in a group session. 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 either in the presence of the patient, or with a third party, such as a carer or family member, and/or other professional or mental health worker.

The majority (94.2%) of service contacts reported in 2017–18 involved individual sessions, and 5.8% of contacts were group sessions. More than half (52.2%) of all contacts were individual sessions where the patient participated in the service contact (termed patient present).

Of the 5 most common specific principal diagnoses, the patients most likely to have an individual contact, where the patient was present, were those diagnosed with a Schizoaffective disorder (62.1%) or Schizophrenia (61.8%). Patients with the stress-related disorder - Reaction to severe stress and adjustment disorder had the highest proportion of service contacts where the patient was absent (48.2%).

Duration of service contacts

The duration of service contacts ranged from less than 5 minutes to over 3 hours. In 2017–18, the average service contact duration was 35 minutes. More than a third of contacts were between 5–15 minutes (38.9%, or about 3.7 million) and around a quarter of contacts were between 16–30 minutes (24.2%, or about 2.3 million) (Figure CMHC.6). Service contacts with the patient present were on average longer in duration, averaging 46 minutes, than those with the patient absent (23 minute average).

 

Figure CMHC.6 Alternative text - Source data:  Community mental health care services tables (745KB XLS).

Of the 5 most commonly reported specific principal diagnoses, Reaction to severe stress and adjustment disorders had the highest proportion of contacts lasting over 1 hour (13.5%). Service contacts lasting less than 5 minutes were not commonly conducted with patients who had 1 of the 5 most frequently recorded specific principal diagnoses (5.2% or less for each principal diagnosis).

Contact duration over time

Issues with some jurisdictions’ data coverage in 2011–12 and 2012–13 (Victoria and Tasmania), 2015–16 (Victoria), 2016–17 (Victoria, New South Wales and the Northern Territory), and 2017–18 (New South Wales and the Northern Territory) have impacted on the ability to undertake long term trend analysis for these jurisdictions, as well as at the national level.

Nevertheless, the average time per contact has steadily declined over the five years to 2017–18, from 47 minutes per contact in 2013–14 to 35 minutes per contact in 2017–18. Since 2013–14, the number of short-duration contacts (under 5 minutes) has increased 4-fold, from 86,742 to 402,195. This increase is mostly due to a change in Queensland’s reporting system during the 2014–15 reporting period, which allows for contact duration to be recorded individually for each consumer seen in group sessions. This system change affects the national average duration of contacts.

Mental health legal status

About 1 in 7 (14.5%, 1,340,130) community mental health care service contacts in 2017–18 involved a patient with an involuntary mental health legal status. Western Australia reported the lowest proportion of involuntary contacts (3.4%), while the Australian Capital Territory reported the highest (34.5%). These differences most likely reflect the different legislative arrangements in place amongst the jurisdictions.

Of the 5 most commonly reported specific principal diagnoses, Schizoaffective disorders accounted for the highest proportion of contacts involving a patient with an involuntary mental health legal status (39.5%), followed by Schizophrenia (34.7%) and Bipolar affective disorder (21.9%). Lower proportions of involuntary mental health legal status service contacts were seen in patients with a principal diagnosis of a Depressive episode (2.6%) and Reaction to severe stress and adjustment disorders (1.8%) (Figure CMHC.7).

 

Figure CMHC.7 Alternative text - Source data:Community mental health care services tables (745KB XLS).

Over the 5 years to 2017–18, the number of community mental health care service contacts with an involuntary legal status increased by an average of 4.2% each year. The proportion of involuntary contacts increased for 4 of the 5 most commonly reported specific principal diagnoses over this time period, however a reduction in the proportion of involuntary contacts was observed for patients with the principal diagnosis of Reaction to severe stress and adjustment disorders (an average decrease of 7.4% each year).

Note that national rates over time should be interpreted with caution. Improvements in the reporting of legal status and issues with data coverage for Victorian and Tasmanian data in 2011–12 and 2012–13 and changes to South Australian legislation and data collection methods for involuntary care in 2010–11 have had an impact on the ability to undertake long term trend analysis of the rate of involuntary contacts.

Target population

Target population refers to the population group that is primarily targeted by a community mental health care service. Community mental health care services are described by 5 target population categories: General, Child and Adolescent, Youth, Older Person and Forensic. Additional information about Community mental health care services can be found in the Specialised mental health care facilities section.

Services targeted toward the General population provided 69.7% of all treatment days in 2017–18, and Child and Adolescent services accounted for 15.2%. Services targeted towards Older Person (6.9%), Forensic (6.5%) and Youth (1.6%) populations accounted for much smaller proportions of treatment days. These results largely mirror the relative size (as measured by the number of staff) for each of the Community mental health care service target population categories (Specialised mental health care facilities section Table FAC.41).