State and territory specialised mental health services

Recurrent expenditure

Around $5.7 billion was spent on state and territory specialised mental health services in 2016–17. The largest proportion of this recurrent expenditure was spent on public hospital services for admitted patients ($2.6 billion), comprising of public acute hospitals with a specialist psychiatric unit or ward ($2.0 billion) and public psychiatric hospitals ($0.6 billion). This was closely followed by expenditure on community mental health care services totalling $2.1 billion.

Per person expenditure on specialised mental health services ranged from $206 per person in Victoria to $305 per person in Western Australia, compared to a national average of $233 per person during 2016–17.

Expenditure on state and territory specialised mental health services, adjusted for inflation, increased by an average annual rate of 2.8% between 2012–13 and 2016–17. This equates to an increase of $11 per person, from $222 in 2012–13 to $233 in 2016–17.

Detailed expenditure data are available covering 24 years to 2016–17. Figure EXP.1 shows the changes in state and territory spending patterns, for example, increased investment in community mental health care services, reflecting changes to the state and territory specialised mental health service profile mix over this time. Further information can be found in the Specialised mental health care facilities section.

 
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Figure EXP.1 Alternative text - Source data: Expenditure on mental health services 2016-17 (474KB XLS).

Funding

The majority (96.5% or $5.5 billion of the $5.7 billion total cost) of funding for state and territory specialised mental health services was provided by state or territory governments in 2016–17, with a further 1.4% ($81 million) provided by the Australian Government, and 2.1% ($118 million) from patients and other revenues and recoveries. However, these funding estimates do not take into account the Australian Government payments to states/territories for the running of public hospitals. Refer to the data source section for technical information regarding Australian Government expenditure.

Public sector specialised mental health hospital services

The $2.6 billion of recurrent expenditure for public sector specialised mental health hospital services during 2016–17 equates to an average cost per patient day of $1,117. The Northern Territory ($1,992) had the highest average cost per patient day, while the average cost in Queensland ($954) was the lowest.

Recurrent expenditure on public sector specialised mental health hospital services can be further described using target population (General, Child and adolescent, Youth, Older person and Forensic target groups), program type (acute and non-acute) or a combination of these.

Target population and program type

Mental health services classified as having a General target population ($1.9 billion or 72.8%) accounted for the majority of recurrent expenditure for public sector specialised mental health hospital services during 2016–17. Child and adolescent services ($2,163 per patient day) had the highest costs per patient day, continuing a long term trend of these services costing more to run than services with a General target population ($1,103 per patient day), Older person ($991 per patient day) and Forensic ($1,100 per patient day) services.

There was an average annual increase in expenditure per patient day for General (2.4%), Child and adolescent (6.7%) and Older person services (3.7%) between 2012–13 and 2016‑17, adjusted for inflation. Expenditure per patient day for Forensic services has remained relatively unchanged since 2012–13.

Average patient day costs for acute public sector specialised mental health hospital services were higher than those for non-acute services for all target population categories in 2016–17.

Community mental health care services

Community mental health care services accounted for $2.1 billion of recurrent expenditure on mental health services during 2016–17, representing 36.9% of total state/territory expenditure in 2016–17.

Residential mental health services

Of the $303 million spent on residential mental health services during 2016–17, the majority was spent on 24-hour staffed services ($262 million or 86.6%). General services ($205 million) accounted for more than two thirds (67.9%) of the total residential expenditure.

The average national cost per patient day for residential mental health services was $433 per day in 2016–17. Average costs varied between states and territories, ranging from $325 per patient day in Western Australia to $671 per patient day in the Northern Territory. Queensland does not currently report residential mental health services.

Expenditure by target population

Recurrent expenditure for public sector specialised mental health hospital, community and residential services can be combined and presented by target population. Expenditure on General services ($229 per person) was the highest of the 5 target populations during 2016–17, reflecting that many jurisdictions do not have the other specialised target population hospital services which contribute substantial costs to the overall expenditure profile. Adjusted for inflation, per capita expenditure between 2012‑13 and 2016–17 has remained relatively stable for General, Child and adolescent and Forensic services while per capita expenditure on Youthservices increased by an average of 15.4% per year. Over this time period, per capita expenditure on Older person services decreased by an average of 2.6% per year. This average annual decrease is likely because expenditure on Older persons services has not increased to the same extent as the increases in the Older persons population. For example, while the adjusted expenditure on Older person services increased 2.5% to $548 million in 2016‑17 compared with 2012‑13, the Older person population (65 years and over) increased by 13.8% to 3.9 million people in 2016–17.

Private hospital specialised mental health services

Adjusted for inflation, expenditure on specialised mental health services in private hospitals increased from $362 million to $536 million between 2012–13 and 2016–17. Per person expenditure increased from $16 per person to $22 per person during this time, an annual average change of 8.6%