Mental health services in Australia

Australian Government expenditure on mental health‑related services

Australian Government expenditure on mental health-related services was estimated to be $3.0 billion in 2016–17. However, as noted previously and detailed in the data source section of this report, there are other known Australian government outlays attributable to supporting mental health issues which are not included in this estimate, for example, disability support pensions and the Australian government’s contribution to public hospital costs.

Australian Government expenditure on mental health-related services, adjusted for inflation, increased by an average annual rate of 0.8% between 2012–13 and 2016–17. This equates to a decrease of $4 per person, adjusted for inflation, from $127 per person in 2012–13 to $123 in 2016–17.

Expenditure on MBS-subsidised mental health-specific services and mental health-related medications provided through the PBS accounted for 55.8% of the total in 2016–17 (Figure EXP.2). The next largest component was spending on National programs and initiatives managed by the Department of Health (23.8%), the Department of Veterans’ Affairs (6.5%) and Private Health Insurance Premium Rebates (5.2%). Since 2007–08, there has been a decrease in the cost of PBS mental health-related subsidised prescriptions and an increase in MBS-subsidised services and programs and National programs and initiatives. Medication prices can reduce for a variety of factors (for example, price disclosure or patent changes), refer to the Mental health-related prescriptions section for more information on the Pharmaceutical Benefits Scheme (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS). Technical information regarding the calculation of these figures can be found in the data source.

Figure EXP.2 Alternative text - Source data: Expenditure on mental health-related services 2016-17 (474KB XLS).

Australian Government expenditure on Department of Defence funded programs has increased by an average of 15.9% per year for the period 2012–13 ($26.6 million) to 2016–17 ($47.9 million), adjusted for inflation. The expenditure covers a range of mental health programs and services delivered to Australian Defence Force (ADF) personnel. When the number of permanent ADF personnel is taken into consideration (58,612 people; Department of Defence, 2017 ) this equates to $818 per permanent ADF member in 2016–17.

Australian Government expenditure on Medicare-subsidised mental health-specific services

More recent expenditure data for 2017–18 Medicare-subsidised mental health-specific services is presented in this section. Throughout this section, Medicare-subsidised mental health-specific services refers to the mental health-specific services subsidised by the Australian Government through the Medicare Benefits Schedule (MBS). These services include mental health-specific services provided by psychiatrists, general practitioners (GPs), psychologists (both clinical and other), and other allied health professionals and are defined in the MBS. Refer to the data source section for further information on the estimation of GP expenditure prior to 2007–08.

In 2017–18, $1.2 billion was paid in benefits for Medicare-subsidised mental health-specific services, equating to 5.3% of total MBS expenditure ($23.5 billion including Dental Benefits Schedule and the Child Dental Benefits Schedule) (DHS 2018). Expenditure for services provided by psychologists ($551 million or 44.4%) made up the largest proportion, comprising mostly Psychological Therapy Services (clinical psychologists; $294 million) and Focussed Psychological Strategies (other psychologists; $252 million). Expenditure on services provided by psychiatrists was the next largest expenditure group ($358 million or 28.9%). GP expenditure comprised $299 million (24.1%) of total Medicare subsidised mental health-related benefits.

Nationally, benefits paid for Medicare-subsidised mental health-related services averaged $49 per person in 2017–18, adjusted for inflation to 2016–17 prices (Figure EXP.3). The average benefits paid per person in Victoria ($56 per person) was the highest, while those in the Northern Territory were the lowest ($14 per person).

Figure EXP.3 Alternative text - Source data: Expenditure on mental health-related services 2016-17 (474KB XLS).

There was an average annual increase of 5.4% in the total expenditure on Medicare-subsidised mental health related services (adjusted for inflation) between 2013–14 and 2017–18. This change equates to an average annual increase (per person) in spending of 3.8%, adjusted for inflation, from $43 in 2013–14 to $49 in 2017–18.

Australian Government expenditure on mental health-related subsidised prescriptions

More recent expenditure data for 2017–18 PBS/RPBS mental health-related subsidised prescriptions are presented in this section. For information on data quality, coverage and other aspects of the PBS and RPBS refer to the data source section. The related Prescriptions section has information about the PBS and RPBS system and data on the number of prescriptions.

Australian Government expenditure on mental health-related subsidised prescriptions under the PBS and RPBS was $534 million, or $22 per person, in 2017–18. This was equivalent to 4.5% of all PBS and RPBS subsidies ($12.1 billion) (DHS 2018). Prescriptions for antipsychotics (48.5%) and antidepressants (32.8%) accounted for the majority of mental health-related PBS and RPBS expenditure in 2017–18, followed by prescriptions for psychostimulants and nootropics (11.4%), anxiolytics (4.7%) and hypnotics and sedatives (2.5%).

Tasmania ($28 per person) had the highest per capita cost of PBS/RPBS medications, and the Northern Territory ($11) the lowest, compared with the national per capita cost of $22 (Figure EXP.4). For most states and territories, the cost of antipsychotics was the largest proportion of PBS/RPBS costs, followed by antidepressants, except for Tasmania where the cost of antidepressants was more than antipsychotics.

Figure EXP.4 Alternative text - Source data: Expenditure on mental health-related services 2016-17 (474KB XLS).

Around three quarters (73.2% or $392 million) of the expenditure on mental health-related subsidised prescriptions was for prescriptions issued by GPs. This was followed by prescriptions written by psychiatrists (16.9% or $90 million ), with non-psychiatrist specialists’ prescriptions accounting for 8.7% ($47 million). Around $6.2 million of prescriptions were dispensed by allied health (primarly nurse practitioners) or where the speciality of the prescriber was unknown.

Real expenditure (constant prices) for mental health-related prescriptions declined between 2013–14 and 2017–18, from $743 million to $535 million. This was likely to be the result of a decrease in the subsided cost of some medications. Medication prices can reduce for a variety of factors (for example, price disclosure); refer to the Mental health-related prescriptions section for more information.