Data source and key concepts

Development and implementation of the Your Experience of Service survey instrument

There has been an increased focus by states and territories on strengthening and coordinating efforts to collect patient reported measures (AIHW 2018). The Your Experience of Service (YES) survey was developed primarily for use in public specialised mental health services.

Monitoring mental health consumer and carer experiences of service has been a long-term goal of the National Mental Health Strategy. In 2010, under the Fourth National Mental Health Plan (Commonwealth of Australia 2009), the Australian Government Department of Health funded the National Consumer Experiences of Care project to develop a survey for use in public mental health services (Victorian DHHS 2013). This project resulted in the development of the YES survey, which was finalised in 2014. The YES survey instrument was developed by the Victorian Department of Health and Human Services under the auspices of the previous Mental Health Information Strategy Standing Committee (MHISSC). Implementation of the YES survey and national reporting of the data is a key action under the Fifth National Mental Health and Suicide Prevention Plan (CHC 2017).

The YES NBEDS was subsequently developed by MHISSC in conjunction with AIHW to collect and monitor consumers’ experiences of service over time. Participating jurisdictions agree to provide data to the YES NBEDS through their state/territory representative on MHISSC.

A measure of carer experiences has also been developed. The Mental Health Carer Experience Survey (MHCES) aims to measure the experiences of carers, such as family members, partners or friends of people who access mental health services. New South Wales implemented the survey in 2018 and Queensland implemented the survey in 2019 (NSW Ministry of Health 2019; Queensland Health 2020). Victoria plans to implement this survey from 2020 (Victorian DHHS 2020).

Participating states and territories

Currently three jurisdictions have implemented the YES survey—New South Wales, Queensland and Victoria—and supplied data from 2015–16 under the YES NBEDS.

In 2019–20, New South Wales and Queensland administered and provided data for the YES.

In New South Wales, 48 organisations administered the YES survey through their specialised mental health service units in 2019–20. New South Wales has publicly reported their YES survey data since 2015–16 ( NSW Ministry of Health 2017a, 2017b, 2018, 2019, 2021).

In Queensland, 20 organisations administered the YES survey through their specialised mental health service units in 2019–20. Queensland has publicly reported YES survey data for the collection periods in 2015, 2016, 2017 and 2019 (Queensland Health 2016, 2017a, 2017b, 2020).

Due to the COVID-19 pandemic, Victoria did not administer the YES survey in 2020 and consequently did not submit to the YES NBEDS for the 2019–20 reporting period (Victorian DHHS 2020). Historical data for Victoria is available in the data tables for the 2015–16 to 2018–19 reporting periods. Victoria has publicly reported their YES survey data in their Annual Mental Health Services Report since 2016–17, including information on their early 2016 (for the 2015–16 reporting period) survey (Victorian DHHS 2017, 2018, 2019).

Table 1: Number of services which administered the YES survey in participating states and territories, 2015–16 to 2019–20

 

2015–16

2016–17

2017–18

2018–19

2019–20

NSW

43

44

49

49

48

Vic

17

17

16

17

n.a.

Qld

18

20

20

20

20

Total

78

81

85

86

68

Data source: YES survey data

Data quality over time

Each state has chosen a method of administration that best suits their local needs. New South Wales has adopted a “continuous” method, where people using their specialised mental health services are offered the YES during every hospital stay or community episode of care. By contrast, Victoria and Queensland have adopted a “snapshot” approach where people using their specialised mental health services are encouraged to complete the YES over a particular time of the year. In Victoria, people using their specialised mental health services were offered the YES over a three month period in 2018 and 2019 (and a two month period in 2016 and 2017). In Queensland, people using their specialised mental health services were offered the YES over a four week period (six weeks for services in rural areas) for collection from 2015 to 2017, and over a six week period in 2019 and 2020.

In 2017–18 Queensland reclassified existing Community Care Units from admitted patient care to residential mental health service units.

YES survey questions

The YES survey comprises 26 questions about a mental health consumer’s perceptions of their treatment and the care they received. Respondents answer each question using the following response scales:

  • For questions 1–17, respondents indicate how often the service did a range of things during their care (1—Never, 2—Rarely, 3—Sometimes, 4—Usually, 5—Always). Examples include: ‘You felt welcome at this service’, ‘Staff showed hopefulness for your future’, and ‘Your opinions about the involvement of family or friends in your care were respected’.
  • For questions 18–26, respondents indicate how well the service performed during their care (1—Poor, 2—Fair, 3—Good, 4—Very Good, 5—Excellent). Examples include: ‘Explanation of your rights and responsibilities’, ‘Access to peer support’, and ‘The effect the service had on your overall well-being’.

Experience of service score

MHISSC developed a nationally agreed scoring methodology to reflect each respondent’s experience of service across 22 questions in the YES survey.

The experience of service score for each respondent is equal to the average response of questions 1–22 multiplied by 20. The resulting overall score converts the individual question responses into a score out of 100.

The proportion of respondents with an experience of service score over 80 on the YES measure was agreed by MHISSC as the metric (indicator) to be used for monitoring consumer experience of service under the Fifth National Mental Health and Suicide Prevention Plan (CHC 2017).

Availability of the YES survey

This section of Mental health services in Australia reports data that has been supplied by participating jurisdictions to the AIHW under the YES NBEDS for the purpose of national reporting.

Outside of this national agreement, the YES survey instrument is being made available by the Australian Government Department of Health for use by appropriate mental health organisations that enter a licensing agreement specifying conditions of use which are aimed at promoting consistency of use and reducing the risk of multiple versions being used.

For further information on use of the YES survey and/or to apply for a licence to use the survey in your organisation, please visit the Australian Mental Health Outcomes and Classification Network website.

Key concepts - Consumer perspectives of mental health services

Key concept Description
Admitted care A specialised mental health service that provides overnight care in a psychiatric hospital or a specialised mental health unit in an acute hospital. Psychiatric hospitals and specialised mental health units in acute hospitals are establishments devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders. These services are 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 disorder/illness.
Ambulatory care

A specialised mental health service that provides services to people who are not currently admitted to a mental health admitted or residential service. Services are delivered by health professionals with specialist mental health qualifications or training. Ambulatory mental health services include:

  • community-based crisis assessment and treatment teams;
  • day programs;
  • mental health outpatient clinics provided by either hospital or community-based services;
  • child and adolescent outpatient and community teams;
  • social and living skills programs;
  • psychogeriatric assessment services;
  • hospital-based consultation-liaison and in-reach services to admitted patients in non-psychiatric and hospital emergency settings;
  • ambulatory-equivalent same day separations;
  • home based treatment services; and
  • hospital based outreach services.

Whether a person was provided care under relevant state or territory mental health legislation compulsory treatment provisions.

The state and territory mental health acts and regulations provide the legislative guidance that safeguards the rights and governs the care of patients with mental illness in admitted patient care, residential care and community-based services. The legislation varies between the state and territory jurisdictions but all contain provisions for the assessment, admission and treatment of patients on an involuntary basis.

A person with involuntary status received care under compulsory treatment provisions.

A person with voluntary status received care that was not under compulsory treatment provisions.

Residential care

A service that is considered by the state, territory or Australian Government funding authorities as a service that:

  • has the workforce capacity to provide specialised mental health services; and
  • employs suitably trained mental health staff to provide rehabilitation, treatment or extended care on-site:
    • to consumers residing on an overnight basis;
    • in a domestic-like environment; and
  • encourages the consumer to take responsibility for their daily living activities.

These services include those that employ mental health trained staff on-site 24 hours per day and other services with less intensive staffing (but the trained staff must be on site for a minimum of 6 hours a day and at least 50 hours per week).

Suitably trained residential mental health care staff may include:

  • individuals with Vocational Education and Training (VET) qualifications in community services, mental health or disability sectors;
  • individuals with tertiary qualifications in medicine, social work, psychology, occupational therapy, counselling, nursing or social sciences; and
  • individuals with experience in mental health or disability relevant to providing mental health consumers with appropriate services.
Specialised mental health services

Specialised mental health services are those with a primary function to provide treatment, rehabilitation or community support targeted towards people with a mental disorder or psychiatric disability. These activities are delivered from a service or facility that is readily identifiable as both ‘specialised’ and ‘serving a mental health care function’.

A service is not defined as a specialised mental health service solely because its clients include people affected by a mental disorder or psychiatric disability.

The definition excludes specialist drug and alcohol services and services for people with intellectual disabilities, except where they are specifically established to assist people affected by a mental disorder who also have drug and alcohol related disorders or intellectual disability.

The services can be sub-units of hospitals that are not, themselves, specialised mental health establishments (for example designated psychiatric units and wards, outpatient clinics etc).

Your Experience of Service National Best Endeavours Data Set (YES NBEDS)

The YES NBEDS is Data Set Specification that describes the YES survey questions and defines coding for responses. The scope of YES NBEDS is state and territory public sector specialised mental health services. Specific information for each data element can be found in the YES NBEDS entry on the METeOR website.