Consumer perspectives of mental health care

Monitoring mental health consumer and carer experiences of service has been a long-term goal of the National Mental Health Strategy. This section presents information about consumer-rated experiences of care in public specialised mental health services using the nationally developed Your Experience of Service (YES) survey.

The YES survey aims to help Australian mental health services and consumers work together to build better services. Currently three jurisdictions have implemented the YES survey—New South Wales, Queensland and Victoria—and are contributing to the Your Experience of Service National Best Endeavours Data Set (NBEDS). Data from the YES survey are available in this section for each jurisdiction from 2015–16; Victoria did not conduct the YES survey during 2019–20 due to the COVID-19 pandemic. For more information on the impact of COVID-19, please see the COVID-19 impact on mental health section.

The data source section provides more detailed information on the development of the YES survey, participating states and territories, and other aspects of the YES data supply.

It is anticipated that YES survey data will become available from additional jurisdictions for future updates.

Data downloads:

XLS DownloadConsumer perspectives of mental health care 2019–20 tables (111KB XLSX)

Consumer perspectives of mental health care 2019–20 section (312KB PDF)

This section was last updated in October 2021.

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Key points

  • New South Wales, Queensland and Victoria have implemented the YES survey to monitor mental health consumers’ experiences of care. Victoria did not conduct the survey during 2019–2020 due to the COVID-19 pandemic.
  • 25,636 consumer-rated experience of service surveys were collected from 68 mental health service organisations in 2019–20.­
  • In admitted care in 2019–20, 87.0% of respondents in NSW and 76.0% in Qld rated the care they received as ‘Good’, ‘Very good’ or ‘Excellent’. Each survey is also given a calculated experience of service score, which averages the consumer’s ratings in their responses to multiple survey questions. Based on this calculation, in 2019–20 70.1% of respondents in NSW and 49.5% in Qld reported a positive experience of service in admitted care.   
  • In ambulatory (non–admitted) care in 2019–20, 89.7% of respondents in NSW and 92.1% in Qld rated the care they received as ‘Good’, ‘Very good, or ‘Excellent’. Based on the calculated experience of service score, 80.3% of respondents in NSW and 81.3% in Qld reported a positive experience of service in ambulatory care.
  • In residential care in 2019–20, 92.3% of respondents in Qld rated the care they received as ‘Good’, ‘Very good’ or ‘Excellent’. Based on the calculated experience of service score, 80.3% of respondents in Qld reported a positive experience of service in residential care.
  • In admitted and ambulatory care, a higher proportion of respondents with Voluntary mental health legal status reported a positive experience of service than respondents with Involuntary legal status.

Returned surveys

A total of 25,636 YES surveys were returned in 2019–20 (Figure CP.1). New South Wales had 22,325 returned surveys and Queensland had 3,311. Between 2015–16 and 2019–20 the number of returned surveys has increased for New South Wales (an average annual change of 13.9%), and decreased for Queensland (an average annual change of -0.5%) (Figure CP.1.1). Note that in New South Wales consumers are offered the survey at the end of each episode of care, while in Victoria and Queensland consumers are encouraged to complete the survey at a particular time in the year (the data source section provides more detailed information on each state’s methodology).

The majority of surveys were received from consumers in admitted and ambulatory (non-admitted) care settings (16,562 and 8,891surveys, respectively) with a smaller number received from consumers in residential care (183). This is consistent with the lower number of consumers accessing residential care services observed in relevant data collections (reported in the section Specialised mental health care facilities of Mental health services in Australia). New South Wales reported zero surveys received from consumers in residential care in 2019–20 and Queensland did not report residential mental health services prior to 2017–18 (Table CP.1). Note that an individual consumer may have completed the survey more than once in the reporting period.

Figure CP.1: Received YES surveys (2015–16 to 2019–20)

Figure CP.1, vertical bar graph showing the number of surveys completed by mental health consumers in 2019–20 for each state, by service setting. Numbers for admitted care: NSW 15,679; Qld 883. Residential care: NSW 0; Qld 183. Ambulatory care: NSW 6,646; Qld 2,245. Source: Table CP.1.
Figure CP.1.1, line graph showing the number of surveys completed by mental health consumers in 2015–16 to 2019–20 for each state. Numbers in 2015–16: NSW 13,242; Vic 2,015; Qld 3,380. Numbers in 2016–17: NSW 20,864; Vic 2,058; Qld 3,458. Numbers in 2017–18: NSW 22,895; Vic 2,512; Qld 3,244. Numbers in 2018–19: NSW 24,775; Vic 2,760; Qld 3,747. Numbers in 2019–20: NSW 22,325; Qld 3,311. Source: Table CP.1. 

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Notes:
1. An individual consumer may have completed the survey more than once in the reporting period.
2. In NSW, consumers are offered the YES survey throughout the year, while in Vic and Qld, consumers are offered the YES over a particular time of year. Comparisons between jurisdictions should be made with caution.

Source data: XLS DownloadConsumer perspectives of mental health care tables 2019–20 (111KB XLSX)

In admitted care settings, 52.2% of the returned YES surveys were from consumers who received care for a period of 1 day to 2 weeks and 8.7% from consumers who received care for more than 6 months. This is in contrast to other settings where consumers typically received care for longer periods—in ambulatory care, 7.4% of surveys were from consumers who received care for 1 day to 2 weeks and 53.0% for more than 6 months; in residential care, 17.7% were for 1 day to 2 weeks and 30.4% for more than 6 months (Table CP.2).

Age group and gender

16,562 YES surveys were received from admitted care consumers in 2019–20. The highest number of responses was from consumers aged 25–34 years (3,184 or 21.1%), followed by consumers aged 35–44 (3,007 or 19.9%) and 45–54 (2,781 or 18.5%). This is consistent with the observed demographic patterns for these data collections. More responses were received from male (50.4%) than female (48.5%) consumers and 171 responses were from consumers who identified as ‘Other’ gender (1.1%).

Of ambulatory (non-admitted) care consumers, there were 8,891 returned YES surveys in 2019–20. The highest number of responses was from consumers aged less than 18 years (1,385 or 16.5%), followed by consumers aged 35–44 (1,350 or 16.1%) and 45–54 (1,328 or 15.8%). More responses were received from female (52.9%) than male (45.9%) consumers and 106 responses were from consumers who identified as ‘Other’ gender (1.3%).

In residential care, Queensland received 183 YES survey responses in 2019–20 and New South Wales reported zero. The highest number of responses was from consumers aged 35–44 (50 or 27.5%) followed by 25–34 (49 or 26.9%) and 18–24 (39 or 21.4%). More responses were received from male (53.8%) than female (46.2%) consumers (Table CP.3).

Indigenous status

Aboriginal and Torres Strait Islander consumers in admitted care returned 1,850 surveys (12.4%) and non-Indigenous Australians returned 13,064 (87.6%). There were an additional 1,648 surveys returned where Indigenous status of the respondent was not stated or not recorded.

Indigenous Australians in ambulatory care returned 858 surveys (10.3%) and non-Indigenous Australians returned 7,502 (89.7%). An additional 531 surveys were returned where Indigenous status of the respondent was not stated or not recorded.

In residential care Indigenous Australians returned 27 surveys (15.3%) and non-Indigenous Australians returned 150 (84.7%). 6 surveys were returned where Indigenous status of the respondent was not stated or not recorded (Table CP.3).

Mental health legal status

Mental health legal status refers to whether or not a person was provided care under the relevant state or territory mental health legislation compulsory treatment provisions. In admitted care, 5,886 (48.2%) returned YES surveys were from consumers with a recorded Involuntary status. There were 1,672 (24.7%) returned surveys in ambulatory care and 65 (44.8%) in residential care from consumers who were also recorded to have Involuntary status (Table CP.3).

Consumers’ ratings of care

The YES survey question, ‘Overall, how would you rate your experience of care with this service in the last 3 months?’ provides an overall indication of a respondent’s experience of care.

In admitted care in 2019–20, a higher proportion of surveys were from consumers who rated the care they received as ‘Excellent’ than ‘Very Good’, ‘Good’, ‘Fair’ or ‘Poor’ in both New South Wales and Queensland (Figure CP.2). In New South Wales, 87.0% of respondents in admitted care rated the care they received as ‘Good’, ‘Very Good’, or ‘Excellent’ and 76.0% of respondents gave these ratings in Queensland.

In ambulatory care a higher proportion of surveys were from consumers who rated their care as ‘Excellent’ than ‘Very Good’, ‘Good’, ‘Fair’ or ‘Poor’ in New South Wales and Queensland. In Queensland, 92.1% of respondents in ambulatory care rated the care they received as ‘Good’, ‘Very Good’, or ‘Excellent’ and 89.7% of respondents gave these ratings in New South Wales. These proportions are higher than those observed for admitted care respondents.

In residential care in 2019–20, a higher proportion of surveys were from consumers who rated their care as ‘Excellent’ than ‘Very Good’, ‘Good’, ‘Fair’ or ‘Poor’. In Queensland, 92.3% of respondents in residential care rated the care they received as ‘Good’, ‘Very Good’, or ‘Excellent’. This proportion is higher than those observed for admitted and ambulatory care respondents.

Figure CP.2: Consumer ratings of care, by state and setting, 2019–20

Interactive vertical bar graph showing the proportion of consumers who rated their experience of service as Poor, Fair, Good, Very Good and Excellent in 2019–20 for each state by service setting. Percentages for admitted care in NSW: Poor 4.7; Fair 8.3; Good 21.6; Very good 26.9; Excellent 38.4. Qld: Poor 10.5; Fair 13.6; Good 26.1; Very good 22.0; Excellent 27.9. Percentages for ambulatory care in NSW: Poor 4.6; Fair 5.6; Good 14.4; Very good 26.6; Excellent 48.8. Qld: Poor 2.8; Fair 5.1; Good 16.7; Very good 24.3; Excellent 51.1. NSW reported 0 surveys in residential care. Percentages for residential care in Qld: Poor 1.1; Fair 6.6; Good 16.4; Very good 25.7; Excellent 50.3. Source: Table CP.4.

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Notes:
1. An individual consumer may have completed the survey more than once in the reporting period.
2. Response to question, 'Overall, how would you rate your experience of care with this service in the last 3 months?'.

Source data: XLS DownloadConsumer perspectives of mental health care tables 2019–20 (111KB XLSX)

Consumers’ experiences of service

A nationally agreed overall score out of 100 has been developed to reflect each respondent’s ‘experience of service’ across 22 questions in the YES survey (Further information on the score methodology can be found in the data source section). A score of 80 or above indicates a positive experience of service.

Using this measure, a higher proportion of returned surveys in ambulatory care and in residential care were from consumers who rated their service positively compared with consumers in admitted care.

In admitted care New South Wales had the highest proportion of respondents with a positive experience of service (70.1%), followed by Queensland (49.5%). In ambulatory care, Queensland had 81.3% of respondents with a positive experience of service, and New South Wales had 80.3%. In residential care, 80.3% of Queensland respondents had a positive experience of service (Figure CP.3).

Positive experience of service by mental health legal status

In admitted care in 2019–20, the proportion of respondents with a positive experience of service score in New South Wales was higher for respondents with Voluntary mental health legal status (76.2%) than Involuntary status (65.0%) and mental health legal status Not reported (67.6%). In Queensland, a higher proportion of respondents in admitted care with a positive experience of service score had a mental health legal status of Not reported (54.5%) than Voluntary status (53.8%) and Involuntary status (45.4%) (Figure CP.3.1).

In ambulatory care, the proportion of respondents with a positive experience of service score was higher for respondents with Voluntary mental health legal status than Involuntary status and mental health legal status Not reported. For example in Queensland, 87.5% of respondents with Voluntary status, 70.4% with Involuntary status, and 79.4% with status Not reported, rated their experience of service positively. This same pattern was also observed for New South Wales.

Positive experience of service by Indigenous status

In admitted care, the proportions of Indigenous respondents who generated a positive experience of service score were lower than the proportions for non-Indigenous Australians. In New South Wales 69.7% of Indigenous respondents and 70.4% of non-Indigenous respondents rated their experience of service positively. In Queensland, 46.4% of Indigenous respondents and 50.4% of non-Indigenous respondents rated their experience of service positively (Figure CP.3.1).

The proportions of Indigenous respondents who had a positive experience of service were also lower than for non-Indigenous respondents in ambulatory care. Queensland respondents had 81.7% of non-Indigenous respondents and 79.9% of Indigenous respondents rating their experience of service positively. In New South Wales the proportions were 81.2% of non-Indigenous and 73.0% of Indigenous respondents.

Figure CP.3: Consumers with a positive experience of service (2015–16 to 2019–20)

Interactive vertical bar graph showing the proportion of consumers with an experience of service score of 80 and above, indicating a positive experience of service, by setting and state for the demographic variables of age group, gender, Indigenous status and mental health legal status in 2019–20. Proportions for a positive experience of service in admitted care, by age group for NSW range from 65.0% for consumers less than 18 years to 74.3% for consumer 65 years and over; Qld ranges from 43.4% for consumers aged 35–44 years to 72.9% for 65 years and over. By gender, NSW ranges from 54.2% for Other to 71.7% for Males; Qld ranges from 40.0% for Other to 56.7% for Not reported. By Indigenous status, NSW ranges from 67.5% for Not reported to 70.4% for Non-Indigenous Australians; Qld ranges from 45.5% for Not reported to 50.4% for Non-Indigenous Australians. By mental health legal status, NSW ranges from 65.0% for Involuntary to 76.2% for Voluntary; Qld ranges from 45.4% for Involuntary to 54.5% for Not reported. Proportions for a positive experience of service in ambulatory care, by age group for NSW range from 73.5% for consumers aged 25–34 years to 87.3% for 65 years and over; Qld ranges from 76.5% for consumers aged 25–34 to 84.0% for 65 years and over. By gender, NSW ranges from 75.4% for Other to 83.4% for Females; Qld ranges from 66.7% for Other to 82.2% for Females. By Indigenous status, NSW ranges from 73.0% for Indigenous Australians to 81.2% for Non-Indigenous Australians; Qld ranges from 79.0% for Not reported to 81.7% for Non-Indigenous Australians. By mental health legal status, NSW ranges from 74.1% for Involuntary to 84.3% for Voluntary; Qld ranges from 70.4% for Involuntary to 87.5% for Voluntary. Source: Tables CP.6 and 7.

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Notes:
1. An experience of service score of 80 and above (out of 100) indicates a positive experience.
2. The experience of service score is the average of survey questions 1-22 multiplied by 20.
3. An individual consumer may have completed the survey more than once in the reporting period.

Source data: XLS DownloadConsumer perspectives of mental health care tables 2019–20 (111KB XLSX)

Summary

Three jurisdictions, New South Wales, Victoria and Queensland, have implemented the YES survey in their public specialised mental health services and supply data for national reporting under the YES NBEDS.

During 2019–20, Australians and Australian mental health services have been impacted by the COVID-19 pandemic. Victoria did not conduct the YES survey in 2019–20 and the number of received surveys received in New South Wales and Queensland was lower than for the previous year.

In 2019–20, a higher proportion of consumers reported positive experiences of service:

  • in ambulatory or residential mental health care compared to admitted settings,
  • if they were recorded as receiving care under Voluntary status rather than Involuntary mental health legal status, and
  • if they reported they were not of Aboriginal and/or Torres Strait Islander origin.

Generally, in 2019–20, higher proportions of consumers who completed the YES survey had a positive experience of service than not. However, 743 consumers in admitted care (about 5.0%) and 347 consumers in ambulatory care (about 4.2%) rated their experience of service as Poor. The YES survey was designed to help Australian mental health services and consumers work together to build better services. The jurisdictions that have implemented the YES survey advise that they have developed local practices to translate the data received from consumers completing the YES survey to drive quality improvement in their services.

Other states and territories are planning to roll out the YES survey in their specialised mental health services. It is anticipated that YES survey data will become progressively available from additional jurisdictions in the next couple of years.